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Case 117373

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Referral category

Disease / syndrome / tumor / condition

Region of interest

upper left maxilla

Referral reason

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1 Files Info

Canaray 117373

1. Progressive bone loss at tooth 25DL

Bone loss is present on the distolingual surface of the coronal two thirds of the root of tooth 25. This bone loss was not present in the scan acquired on April 20, 2016 (Canaray Case 84517). The bone loss extends into the mesial furcal region of tooth 26. The source of the bone loss is not radiographically evident, and could be a locally infected region of graft material or a sign of an infiltrative malignancy. The bone in the periapical region of tooth 25 appears normal, which suggests that the tooth is not the source of the pathology. A biopsy of the tissue in the distolingual region of tooth 25 is recommended in order to determine the diagnosis.

2. Widened PDL space of tooth 26P

The periodontal ligament space surrounding the palatal root of tooth 26 is slightly widened in the region adjacent to the bone graft. The source of this periodontal ligament space widening is not radiographically evident. Incidentally, extruded sealer is present at the mesial aspect of the coronal third of the root of this tooth at the level of the restorative margin. It is possible that this extruded sealer is a potential source of gingival irritation.

Axial views of sites 25 and 26

These axial cross sectional images demonstrate the localized bone loss that is present at the lingual aspect of the alveolar crest in the interradicular region of teeth 25 and 26. The bone loss has a slightly irregular shape, and has effaced the lamina dura on the distolingual surface of the coronal third of the root of tooth 25. The source of the bone loss is not radiographically evident. The normal appearances of the periapical regions of teeth 25 and 26 are evident in these images.

Buccolingual views of sites 25 and 26

These buccolingual cross sectional images demonstrate the localized bone defect that is present in the lingual aspect of the alveolar crest between sites 25 and 26.

Mesiodistal views of posterior second quadrant

These mesiodistal cross sectional images demonstrate the irregularly shaped bone defect that is present at the distolingual aspect of the root of tooth 25. The defect is non-corticated, and abuts the grafted material that surrounds the palatal root of tooth 26. The widened periodontal ligament space surrounding the palatal root of tooth 26 is evident in these images.

3. Mild mucositis of left maxillary sinus

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