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Case 113474

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Referral category

Troublesome / painful / cracked tooth (Endodontic)

Region of interest

47

Referral reason

[Only visible to logged-in users]

1 Files Info

Canaray 113474

1. Furcal bone loss at accessory lingual root of tooth 47

Tooth 47 is a morphologic variant with an accessory lingual root budding off the mesial root of the tooth. Rarefying osteitis is present in the periapical region of this unobturated lingual root, as well as on the furcal surface of the coronal half of the mesial root of the tooth. The root canal within this accessory lingual root is not clearly visible, which suggests that it may not be amenable to obturation. The distal root of tooth 47 appears normal radiographically. Overall, this pattern of bone loss is not suggestive of a root fracture and is likely secondary to the unusual root morphology.

Axial views of tooth 47

These axial cross-sectional images demonstrate that tooth 47 is a morphologic variant whereby its mesial root has an accessory lingual root budding off it. The rarefying osteitis in the periapical region of this lingual root, as well as on the furcal surface of the coronal half of the mesial root is evident in these images. There are no radiographic signs of root perforation in this tooth.

Mesiodistal views of tooth 47

These mesiodistal cross-sectional images demonstrate the presence of rarefying osteitis associated with the accessory lingual root apex, as well as the furcal surface of the coronal half of the mesial root of tooth 47. The remaining periradicular bone mesial and distal to the roots appears normal.

Buccolingual views of tooth 47

These buccolingual cross-sectional images demonstrate the rarefying osteitis at the accessory lingual root apex, as well as the furcal surface of the coronal half of the mesial root of tooth 47. The remaining alveolar bone surrounding the roots of the tooth appears normal.

2. Rarefying osteitis at tooth 46M

A small focus of rarefying osteitis is present in the periapical region of the mesial root of tooth 46. The bone surrounding the remaining root surfaces of the tooth appears normal. No unobturated canals are visible in tooth 46. No signs of root fracture are present. Overall, this radiographic appearance is suggestive of a healing post-treatment appearance or a persistent low-grade endodontic lesion at the mesial root apex of tooth 46.

Axial views of tooth 46

These axial cross-sectional images demonstrate the periapical epicenter of the rarefying osteitis at the mesial root of tooth 46. No unfilled canals are radiographically evident.

Mesiodistal views of tooth 46

These mesiodistal cross-sectional images demonstrate the normal appearance of the alveolar bone along the mesial and distal surfaces of the roots of tooth 46. Note the periapical pathology at the mesial root apex.

Buccolingual views of tooth 46

These buccolingual cross-sectional images demonstrate rarefying osteitis at the mesial root apex of tooth 46, as well as the intact alveolar bone on the remaining buccal and lingual surfaces of the roots of the tooth. The mesial and distal root apices of the tooth are separated from the inferior alveolar nerve canal by 6.6 mm and 5.7 mm, respectively.