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Case 117142

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Referral category

Dental implants

Region of interest

anterior mandible

Referral reason

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1 Files Info

Canaray 117142

2. Healing donor site in anterior left mandible: low bone density

The donor site appears to be located within the symphyseal region apical to this bone graft, and granular bone is evident lining this defect, which indicates healing. The density of this granular bone is presently lower than that of the surrounding trabecular bone.

1. History of onlay bone grafting in anterior left mandible

A block bone graft is evident along the buccal aspect of the alveolar process at sites 32 and 31. The bone graft is stabilized by two fixation screws, and appears fully osseointegrated with the underlying buccal cortex.

3. History of onlay bone grafting in anterior right mandible

A block onlay bone graft is evident along the buccal aspect of the alveolar process at sites 41 and 42. The graft is stabilized by two fixation screws, and appears fully osseointegrated with the underlying buccal cortex.

4. Healing donor site in anterior right mandible: low bone density

The mandibular right symphyseal region appears to be the donor site from this bone graft. Granular bone is evident lining this defect, which indicates healing. The density of this granular bone is presently lower than that of the surrounding trabecular bone.

5. Periradicular bone loss in tooth 36D

Tooth 36 is partially captured in this imaging volume. Localized periradicular bone loss is evident along the mesiobuccal surface of the distal root of this tooth, which extends from the alveolar crest to the mid-root region. The buccal cortex overlying this region appears partially dehiscent. There are no radiographic signs of root perforation adjacent to this area. This could infer the possibility of a non-displaced root fracture. Complete CBCT imaging of this tooth is recommended.

6. Widened PDL space on tooth 36M

There is widening of the periodontal ligament space around the mesial root apex of tooth 36. The existing obturations in its mesiobuccal and mesiolingual canals extend to their apices. These findings could suggest the persistent low-grade endodontic pathology or a healing post-treatment appearance. Continued radiographic monitoring is recommended.

7. Prominent apical delta canals in tooth 43

Multiple radiolucent channels are evident in the apical third of the root of tooth 43. The periapical and periradicular bone surrounding the root of this tooth appears normal. This likely reflects the presence of prominent apical delta canals, which should not be misinterpreted as fracture planes.

Generalized periodontal bone loss

There is generalized mild to moderate horizontal bone loss involving the imaged dentition.

History of hypophosphatemia

The enamel lining the imaged dentition appears thin, and their pulp spaces enlarged. The root dentin exhibits a slightly lower density than the expected range of normal. The buccal and lingual cortices of the mandible appear thin, but intact. The internal bone pattern is composed of faint trabecular septa and numerous small marrow spaces. These findings are characteristic of a history of hypophosphatemia.

8. Prominent genial tubercles

The osseous projections along the lingual aspect of the anterior mandibular body represent prominent genial tubercles, which are normal anatomic variants and non-significant incidental findings.