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Troublesome / painful / cracked tooth (Endodontic)
Region of interest
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1. Benign unilocular intraosseous lesion between teeth 33 and 34
A well-defined non-corticated unilocular radiolucent entity has formed between teeth 33 and 34 at the midroot level. This entity has extended through the lingual cortex of the alveolar process without causing any lingual expansion. Mild displacement of the attached gingival tissue has occurred. Teeth 33 and 34 have not been affected.
Although this lesion has some aggressive characteristics, such as a non-corticated periphery and cortical perforation with expansion, it has more characteristics that are suggestive of a benign lesion, such as a unilocular shape, an origin within bone, and the absence of widened periodontal ligament spaces on the adjacent teeth. Therefore, this most likely represents a benign aggressive lesion, which requires a biopsy in order to obtain a diagnosis.
Axial views of mandibular arch
These axial cross-sectional images demonstrate the intact lamina dura on the distal surface of tooth 33, as well as the extension of the unilocular lesion around the mesiolingual surface of tooth 34. The lamina dura has been locally lost in this region, but there have been no other effects on tooth 34. Mild thickening of the overlying attached gingival mucosa is present on the lingual surface of the alveolar process adjacent to this region. Note the absence of cortication at the periphery of the lesion, as well as the absence of similar lesions in the region.
Buccolingual views of teeth 33 and 34
These buccolingual cross-sectional images demonstrate the localized loss of the cortex on the lingual surface of the alveolar process between teeth 33 and 34.
Mesiodistal views of mid-third quadrant
These mesiodistal cross-sectional images demonstrate the apposition of the unilocular radiolucent lesion against the mesiolingual surface of tooth 34, as well as the absence of any damage to the lamina dura on the distal surface of tooth 33.
2. Dense bone island in anterior mandible
A dense bone island is present in the anterior mandible apical to tooth 41. This is a non-significant incidental finding, and is continuous with the adjacent trabecular bone.