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Case 111819

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Referral category

Dental implants

Region of interest

Upper and Lower CT with Simplant Version

Referral reason

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Canaray 111819

1. Periodontal-endodontic lesion on tooth 43

There is extensive circumferential bone loss around the root of tooth 43, which extends from the alveolar crest to involve its periapical region. These findings suggest inflammatory disease arising from a combined endodontic and periodontal origin. Extraction of this tooth is indicated.

Healing extraction sockets at sites 21, 22, 23

Moderately well-defined defects are evident along the crestal aspect of the alveolar process at site 21, 22, and 23, which suggests a history of tooth extraction in these regions. Granular bone is observed lining these defects, which indicates healing. The density of this granular bone is significantly lower than that of the surrounding trabecular bone, which suggests that these teeth were recently extracted.

2. Palatal exostosis

An exostosis comprised of cortical and trabecular bone is present at the palatal aspect of the alveolar process adjacent to site 28. This exostosis represents an incidental finding and does not require intervention.

3. Dense bone island at site 36

A dense bone island is present in the buccal aspect of the alveolar process at site 36. This dense bone island demonstrates no effects on its surrounding structures. This is a non-significant incidental finding.

4. Mild mucositis of both maxillary sinuses

Mild mucositis is present in both maxillary sinuses. This represents an incidental finding with no clinical significance.

Sagittal views of the left maxillary sinus

These sagittal cross-sectional images demonstrate the presence of mild mucositis in the left maxillary sinus, which should not impede a sinus lift procedure.

5. Transverse ridge apical to site 24

A transverse ridge is present along the floor of the maxillary sinus apical to site 24, which may impede a sinus lift procedure in this region.

Sagittal views of the right maxillary sinus

These sagittal cross-sectional images demonstrate the presence of mild mucositis in the right maxillary sinus, which should not impede a sinus lift procedure.

6. Transverse ridges apical to sites 15, 18

Transverse ridges are evident along the floor of the maxillary sinus apical to sites 15 and 18, which may impede a sinus lift procedure in these regions.

7. Sphenoid sinus mucositis

Mild mucositis is present in the left loculation of the sphenoid sinus. This is a non-significant incidental finding.

8. Palatine tonsilloliths

Tonsilloliths are present in the palatine tonsils. This is an incidental finding with no clinical significance due to the spontaneous exfoliation of tonsilloliths.

9. Atlanto-occipital and C2-C3 fusion

The Atlas (first cervical vertebra) appears completely fused with the skull base. As well, the body and lateral masses of the C2 vertebra appear fused with those of the C3 vertebra. Although these findings represent a rare developmental anomaly, they could predispose the patient to neurological symptoms, and may signify the presence of a Chiari malformation. Referral to a physician for further investigation may be considered, particularly if the patient reports any pain in the cervical region.

Coronal views of the cervical vertebrae

These coronal cross-sectional images demonstrate the fusion of the Atlas vertebra with the base of the skull, and the fusion of the body and lateral masses of the C2 vertebra with those of the C3 vertebra.