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Case 114641

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Referral category

Disease / syndrome / tumor / condition

Region of interest

mandibular anterior - see notes

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1 Files Info

Canaray 114641

1. Periradicular bone loss on tooth 41L

Periradicular bone loss is evident along the lingual aspect of tooth 41, which extends from the alveolar crest to the apex of its root. As a result, the lingual half of the root of this tooth is bereft of osseous coverage. A small spicule of the former lingual cortical plate remains attached to the lingual surface of the apical half of the root of tooth 41. Although this bone loss extends laterally to abut the mesiopalatal aspects of the adjacent teeth 31 and 42, these teeth remain mostly unaffected, and their lingual cortical plates appear intact. There is no radiographic evidence of endodontic pathology involving teeth 31, 41, and 42, but clinical vitality testing is recommended to substantiate this interpretation. These findings are consistent with the reported history of chronic trauma arising from a tongue piercing.

Axial views of teeth 31, 41, 42

These axial cross-sectional images demonstrate the presence of periradicular bone loss along the mesiolingual and distolingual aspects of tooth 41, which extends from the alveolar crest to its root apex. The lingual half of the root surface of this tooth appears to be bereft of osseous coverage.

Buccolingual views of teeth 31, 41, 42

These buccolingual cross-sectional images demonstrate that a small spicule of the original lingual cortical plate remains attached to the apical half of the root of tooth 41. The remaining lingual cortical plate has been lost. The lingual cortical plates overlying teeth 31 and 42 appear thin, but intact.

Mesiodistal views of teeth 31, 41, 42

These mesiodistal cross-sectional images demonstrate that the periradicular bone loss associated with tooth 41 extends laterally to abut the coronal two-thirds of the roots of teeth 31 and 42. The periapical bone surrounding these teeth appear relatively normal, and there is no evidence of endodontic pathology.

2. Caries on tooth 16M

Caries may be present along the mesial aspect of tooth 16, which appear to extend into dentin. Bitewing radiography is necessary to substantiate this interpretation.

3. Caries on tooth 46M

A small carious lesion is evident along the mesial aspect of tooth 46, which appears to just extend into dentin. Bitewing radiography is recommended to substantiate this interpretation.