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Case 108534

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Referral category

Dental implants

Region of interest

#31

Referral reason

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Canaray 108534

Orthogonal measurements at site 31

These orthogonal cross-sectional images demonstrate the mesiodistal and buccolingual dimensions of the available bone at site 31. The limiting factor for implant placement at this site is the narrow buccolingual width due to the buccal concavity and the narrow mesiodistal space between the tooth 32 and implant 41. The bone of the site 31 appears normal , otherwise.

1. Thin buccal bone overlying implant 41

The buccal cortical bone overlying the middle third of the implant at site 41 is thin and may be partially dehiscent. The mesial, distal, and lingual crestal bone levels appear normal.

2. Possible lateral periodontal cyst interradicular to teeth 34 and 35: Botryoid type

Two small, well-defined,and corticated radiolucencies with two locules are present interradicular to the roots of teeth 34 and 35. The contiguous lamina dura of tooth 34 is effaced at the distolingual surface of the root, but no root resorption is evident. The buccal and lingual cortical plates overlying the lesion are intact. The remainder of the periradicular bone of tooth 34 appears normal. This may represent a botryoid type lateral periodontal cyst. However, the possibility of other cystic tumour such as a keratocystic odontogenic tumour cannot be ruled out. Excisional biopsy and histopathologic examination of the cyst are indicated.

Mesiodistal views of mid-3rd quadrant

These mesiodistal cross-sectional images demonstrate the extension of the two small locules of the cystic lesion interradicular to teeth 34 and 35 in the left mandible. Tooth 36 is unaffected and appears normal.

Axial views of mid third quadrant

These axial cross-sectional images demonstrate the interradicular and lingual position of the multilocular cystic lesion in the interradicular region of teeth 34 and 35. Note the absence of any root resorption to teeth 34 and 35.

Buccolingual views of mid-third quadrant

These buccolingual cross-sectional images demonstrate the absence of any significant buccolingual expansion of the alveolar process adjacent to the cystic lesion. Note that the two small locules of the lesion communicate.