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Case 106215

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Referral category

Disease / syndrome / tumor / condition

Region of interest

44-47

Referral reason

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Canaray 106215

1. Sequestered lingual crestal bone at site 46/47

The lingual crestal bone at site 46/47 exhibits sequestration. The underlying trabecular bone appears normal. Sequestration of the crestal bone in this region likely reflects an early sign of osteomyelitis related to the patient's purported use of anti-resorptive agents for the treatment of osteoporosis.

2. Lingual mandibular tori

Lingual tori composed of cortical bone are present in the alveolar process of the mandible adjacent to teeth 33, 34, and 35. These tori are comprised of cortical bone, and the underlying trabecular bone demonstrates a normal appearance. No signs of sequestration are evident at this time.

Axial views of posterior 4th quadrant

These axial cross-sectional images demonstrate a normal appearance of the alveolar bone underling the lingual mandibular tori.

Mesiodistal views of mid-4th quadrant

These mesiodistal cross-sectional images demonstrate the sequestered crestal bone along the lingual aspect of the alveolar crest at sites 46/47. The remainder of the alveolar process appears normal at this time.

Buccolingual views of mid-4th quadrant

These buccolingual cross-sectional images demonstrate the lingual position of the sequestered crestal bone at sites 46/47.

Normal tooth 45

Tooth 45 appears normal radiographically. The periodontal ligament space is of uniform width around the root circumference of the tooth and the lamina dura is intact. No signs of endodontic or periradicular pathology are present.

Normal tooth 44

Tooth 44 appears normal radiographically. The periodontal ligament space appears thin and uniform, and the lamina dura is intact. The periapical and periradicular bone appears normal.

3. Buccal and palatal exostoses in maxilla

Buccal exostoses are present overlying the maxillary anterior teeth, and small palatal exostoses are present adjacent to site 17. These are non-significant incidental findings.

Axial views of maxilla

These axial cross-sectional images demonstrate the small exostoses overlying the buccal aspects of the maxillary anterior teeth, as well as along the palatal aspect of the alveolar process at site 17. Note the normal appearance of the alveolar bone within the maxilla. No signs of osteomyelitis are present.

Axial views of mandible

These axial cross-sectional images demonstrate the presence of mandibular tori adjacent to the right and left canine-premolar regions. The tori appear normal bilaterally and do not demonstrate any evidence of sequestration.

4. Extracranial calcification of carotid arteries

Extensive calcifications are visible lining the walls of the right and left carotid arteries at the level of C3/C4. These findings may be a sign of atherosclerosis and cardiovascular disease.

5. Calcification of left vertebral artery

Calcifications are visible lining the walls of the left vertebral artery. This finding may be a sign of atherosclerosis and cardiovascular disease.

6. Intracranial calcification of internal carotid arteries

Calcifications are visible lining the walls of the cavernous segments of the right and left internal carotid arteries. These findings may represent signs of cerebral atherosclerosis. The significance of this finding cannot be determined based on CBCT imaging alone.

Mild degenerative joint disease in the left TMJ

Articular flattening, mild subchondral sclerosis, and osteophyte formation are present on the left condylar head. This appearance is suggestive of the presence of mild degenerative joint disease.

7. Moderate cervical degenerative joint disease

Osteophytes and subchondral sclerosis are present in the articulating regions of the cervical vertebrae. The left lateral articulating surfaces of C4 and C5 appear to be fused. This is an incidental finding that is suggestive of moderate cervical degenerative joint disease.

8. Calcified stylohyoid ligaments

The stylohyoid ligaments are partially calcified bilaterally. This is an incidental finding with no clinical significance.