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Referral details

Case 106270

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Referral category

Troublesome / painful / cracked tooth (Endodontic)

Region of interest

14 implant region / right maxillary sinus

Referral reason

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Canaray 106270

Evaluation of implant 14 + possible treatment

The implant at site 14 is normally integrated. No signs of peri-implant bone loss are present. No signs of implant failure are present. The apex of the implant is positioned at the sinus floor, but in the absence of any adjacent sinus pathology, this is a nonsignificant incidental finding.

It is possible for an implant to appear normal radiographically while still producing symptoms of neuralgia. The patient has two choices: Either remove the implant, while understanding that there is no guarantee that implant removal would alleviate the symptoms, or accept the condition of neuralgia, and have a neurologist manage the pain symptoms pharmacologically. One technique to ascertain whether the symptoms are caused by nerves in the immediate vicinity of the implant is to perform a local infiltration of anesthetic in the peri-implant region, and evaluate whether the symptoms cease or not. This may help in the decision process regarding implant removal or a referral to a neurologist.

1. Small flecks of retained endodontic sealer apical to implant 14

Two small flecks of endodontic sealer are retained in the periapical region of the implant at site 14. Normal bone surrounds this endodontic sealer, which suggests that this is a non-significant incidental finding, and is not the source of the patient's symptoms.

Axial views of implant 14

These axial cross-sectional images demonstrate the normal osseointegration of the implant at site 14. Beam hardening artifacts are present on the mesial and distal surfaces of the implant. No bone loss has occurred in these regions.

Mesiodistal views of site 14

These mesiodistal cross-sectional images demonstrate the normal appearance of the alveolar bone on the mesial and distal surfaces of implant 14. No pathology is radiographically evident in the mid-first quadrant.

Mesiodistal views of tooth 14

Buccolingual views of implant 14

These buccolingual cross-sectional images demonstrate the normal appearance of the alveolar bone on the buccal and palatal surfaces of the implant at site 14. No signs of peri-implant bone loss are radiographically evident.

Buccolingual views of tooth 14

2. Mild mucositis of right maxillary sinus

The right maxillary sinus exhibits mild mucositis, which represents an incidental finding with no clinical significance.