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Referral details

Case 118869

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Referral category

Troublesome / painful / cracked tooth (Endodontic)

Region of interest

11, 12, 13, 21

Referral reason

[Only visible to logged-in users]

1 Files Info

Canaray 118869

Rule out infiltrative malignancy

The periodontal ligament spaces are irregularly widened around all of the roots of the teeth that are visible in the field of view. This periodontal ligament space widening does not have an epicenter at any of the root apices of the teeth and does not appear to be associated with the vitality of any tooth. Irregularly shaped widened periodontal ligament spaces are highly suggestive of infiltrative malignancies. This is the putative diagnosis unless proven otherwise.

1. Widened periodontal ligament space of tooth 13

The periodontal ligament space surrounding the root of tooth 13 is irregularly widened. This pattern of bone loss is unusual. Low-density heterogeneous bone is present in the periapical region of the tooth. This does not appear to be a lesion of endodontic origin. Buccal abrasion is present at the coronal third of the root of tooth 13. This is a non-significant incidental finding.

Axial views of tooth 13

Mesiodistal views of tooth 13

Buccolingual views of tooth 13

2. Irregularly shaped zone of bone loss at tooth 12

An irregularly shaped zone of bone loss is present around the coronal half of the root of tooth 12. This bone loss does not appear to have an endodontic origin. No signs of root fracture are present in the tooth.

Axial views of tooth 12

Mesiodistal views of tooth 12

Buccolingual views of tooth 12

3. Irregularly widened periodontal ligament space of tooth 11

The periodontal ligament space surrounding the root of tooth 11 is irregularly widened. No pathology is present adjacent to the apical foramen of this tooth. Small dehiscences are present in the buccal cortical plate adjacent to the tooth.

Axial views of tooth 11

Mesiodistal views of tooth 11

Buccolingual views of tooth 11

4. Irregularly widened periodontal ligament space of tooth 21

The periodontal ligament space surrounding the root of tooth 21 is irregularly widened. This pattern of periodontal ligament space widening does not have an endodontic origin.

Axial views of tooth 21

Buccolingual views of tooth 21

Mesiodistal views of tooth 21

5. Irregularly widened periodontal ligament space of tooth 22

The periodontal ligament space surrounding the root of tooth 22 is irregularly widened. This pattern of bone loss does not appear to have an endodontic origin. The buccal cortical plate is partially dehiscent adjacent to tooth 22.

Axial views of tooth 22

Buccolingual views of tooth 22

Mesiodistal views of tooth 22

6. Buccal abrasion of multiple teeth

Abrasion is present on the buccal surfaces of the coronal thirds of the roots of teeth 13 and 14. This abrasion does not appear to have had any effects upon the root canals of the tooth.