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Case 116850

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Referral category

Troublesome / painful / cracked tooth (Endodontic)

Region of interest

36

Referral reason

[Only visible to logged-in users]

1 Files Info

Canaray 116850

Orthogonal images of bilobed radiolucent lesion apical to tooth 36M from prior scan dated March 19, 2014

These orthogonal cross-sectional images demonstrate a bilobed radiolucent region in the apical region of the mesial root of tooth 36. The periphery of this lesion is corticated and the epicenter is the apical foramen of the mesial root of the tooth. The shape of this lesion is slightly atypical for periapical rarefying osteitis. The distal root of the tooth appears normal. A dense bone island is present in the apical region of the distal root. No unfilled canals are present in tooth 36. No signs of root fracture are present.

1. Bilobed periapical radiolucency associated with tooth 36M from current scan dated September 27, 2016

The current scan dated September 27, 2016, exhibits minimal radiographic changes associated with the bilobed periapical radiolucency at the mesial root apex of tooth 36. A slight increase in the size of the posterior locule and a slight decrease in the size of the anterior locule are noted. The contiguous cortical plates remain intact. Due to the atypical appearance for an area of rarefying osteitis, continued radiographic monitoring is recommended.

2. Dense bone island apical to tooth 36D

A dense bone island is present in the periapical region of the distal root of tooth 36. The appearance of this dense bone island is also unchanged since the prior imaging study.

Overlay demonstrating slight decrease in size of anterior locule

These orthogonal cross-sectional images demonstrate a slight decrease in the size of the anterior locule within the apical region of the mesial root of tooth 36. Note that the prior scan is shaded in blue, and the current scan is shaded in red.

Overlay demonstrating slight increase in size of posterior locule

These orthogonal cross-sectional images demonstrate a slight increase in the size of the posterior locule within the apical region of the mesial root of tooth 36. Note that the prior scan is shaded in blue, and the current scan is shaded in red.

Axial views of tooth 36

These axial cross sectional images demonstrate the periapical epicenter of bone loss associated with the mesial root of tooth 36. No unfilled canals are evident in either root.

Buccolingual views of tooth 36

These buccolingual cross-sectional images demonstrate approximately 7.1mm and 8.9mm between the mesial and distal root apices of tooth 36 and the mandibular nerve canal, respectively. The buccal and lingual cortical plates are intact overlying the radiolucency associated with the mesial root apex of tooth 36.

Mesiodistal views of tooth 36

These mesiodistal cross sectional images demonstrate the bilobed shape of the periapical lesion associated with the mesial root of tooth 36. The dense bone island adjacent to the distal root of the tooth is also evident in these images. Both entities are unchanged in appearance since the previous imaging study.