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Case 114033

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Referral category

Disease / syndrome / tumor / condition

Region of interest

32-42

Referral reason

[Only visible to logged-in users]

1 Files Info

Canaray 114033

1. Benign odontogentic tumor in anterior and left mandibular body

A well-defined radiolucent entity with a well-defined corticated periphery and a multilocular appearance is present in the mandible. This entity extends mesiodistally from the apical region of site 36 to the apical region of tooth 43, and has not caused significant buccolingual expansion of the alveolar process. The buccal and lingual cortical plates have been thinned, however. The entity exhibits a history of marsupialization in the periapical regions of the anterior mandibular teeth, and granular bone has formed in this region. However, multiple daughter "cysts" are present in the periapical regions of the mandibular incisors. This radiographic appearance is suggestive of an incompletely treated odontogenic keratocyst with multiple daughter cysts in the periapical regions of the mandibular incisors.

2. Orthogonal views demonstrating the separation of daughter lesions from the main lesion

The mesiodistal and buccolingual cross sectional images demonstrate the presence of multiple daughter cystic lesions in the periapical regions of the mandibular incisors. The axial view demonstrates the large primary lesion.

2. Orthogonal views demonstrating the separation of daughter lesions from the main lesion

The mesiodistal and buccolingual cross-sectional images demonstrate the presence of multiple daughter cystic lesions in the periapical regions of the mandibular incisors. The axial view demonstrates the large primary lesion.

Axial views of anterior left mandible

These axial cross sectional images demonstrate the granular appearance of the bone in the periapical regions of the mandibular incisors, as well as the multiple small unilocular cystic lesions that are interspersed through this granular bone. The large fusiform entity that has thinned the buccal and lingual cortical plates of the inferior mandibular border is also evident in these images.

Coronal views of anterior left mandible

These coronal cross-sectional images demonstrate the mild buccolingual expansion of the left mandibular body by the cystic lesion. The presence of multiple regions in the anterior mandible is evident in these images, particularly in the periapical regions of the anterior teeth.

Sagittal views of anterior left mandible

These sagittal cross-sectional images demonstrate the minimal buccolingual expansion of the alveolar process in the anterior mandible, as well as the multilocular nature of the lesion. The lamina dura has been lost in the periapical region of tooth 35 in the region adjacent to the lesion.

3. Buccally displaced left inferior nerve canal

The left inferior alveolar nerve canal has been buccally displaced by the lesion in the anterior left mandible. The border of the canal remains intact.

4. Unilocular lesion in periapical region of teeth 41 and 42

A unilocular radiolucent lesion is present in the periapical regions of teeth 41 and 42. This entity has caused loss of the lamina dura in the periapical regions of the roots of these two teeth. Early signs of root resorption may be present. The vitality of teeth 41 and 42 should be assessed to confirm that these teeth are not the source of the lesion.

Axial views of tooth 42

Mesiodistal views of tooth 42

Buccolingual views of tooth 42

Orthogonal views of tooth 41

These orthogonal cross sectional images demonstrate the radiolucent lesion that is present in the periapical region of tooth 41. This radiolucent lesion extends into the periapical region of tooth 42 as well. The root apex of the tooth may exhibit early signs of resorption. Tooth 41 appears normal otherwise.

Axial views of tooth 41

Mesiodistal views of tooth 41

Buccolingual views of tooth 41

5. Multilocular radiolucent lesion around tooth 31

A multilocular radiolucent lesion is present around the apical half of the root of tooth 31. This entity does not originate at tooth 31, and extends to the buccal and lingual cortical plates. The granular appearance of the bone in the region surrounding the multilocular entity is evident in these images.

Axial views of tooth 31

Buccolingual views of tooth 31

Mesiodistal views of tooth 31

6. Multilocular entity around tooth 32

A multilocular cystic entity is present in the region surrounding the apical third of the root of tooth 32. This lesion does not originate in the apical foraminal region of tooth 32, and extends through the buccal and lingual cortical plates.

Horizontally impacted tooth 48

Tooth 48 is horizontally impacted. The right inferior alveolar nerve canal passes inferiorly to tooth 48. No damage has occurred to the distal surface of tooth 47. The follicle surrounding the crown of tooth 48 appears normal.

Axial views of tooth 32

Buccolingual views of tooth 32

Mesiodistal views of tooth 32

Inverted supernumerary tooth apical to tooth 21

An inverted supernumerary tooth (s) is developing in the region apical and palatal to tooth 21. This supernumerary tooth resembles a deciduous canine, and has not had any effect on the surrounding structures. The follicle surrounding the crown of the tooth appears normal, and the periodontal ligament space is of uniform width around the root. This is a non-significant incidental finding.

7. Mild mucositis of right maxillary sinus

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

8. Elongated styloid processes

The styloid processes are elongated bilaterally. This is an incidental finding with no significance.

9. Calcified cornua of thyroid cartilage

Both cornua of the thyroid cartilage are partially calcified. This is an incidental finding with no significance.