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Region of interest
THE LOWER ARCH
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Normal sites 45, 46, and 47
Sites 45, 46, and 47 appear normal radiographically. No intraosseous pathology is present.
Periodontal bone loss on teeth 44, 42, and 41
Teeth 44, 42, and 41 demonstrate moderate horizontal periodontal bone loss.
1. Perio-endo lesion on tooth 43
Tooth 43 demonstrates circumferential periradicular bone loss as well as periapical rarefying osteitis. The buccal cortical plate is lost adjacent to this tooth. This suggests the presence of a combination periodontal-endodontic lesion.
2. Benign bone-forming tumor buccal to left anterior mandible
A well-defined area of exophytic bone formation is present along the buccal aspect of the alveolar process of the left anterior mandible. This area is incompletely captured in this imaging volume. The contiguous buccal cortical plate is concentrically expanded, but remains intact. The internal aspect of this lesion is comprised of heterogeneous granular and sclerotic bone, which blends with the underlying trabecular bone.
These radiographic findings are consistent with a benign, bone-forming neoplasm. The possibility of an ossifying fibroma should be considered. A biopsy and histopathologic evaluation is required for a definitive diagnosis. Complete imaging of the involved area is also recommended.
3. External resorption or iatrogenic damage on tooth 32Bu
The area of exophytic bone formation along the buccal aspect of the left anterior mandible abuts the buccal surface of the root of tooth 32. A prominent radiolucent defect is present along the buccal surface of the root of tooth 32, which abuts the root canal system. This may reflect an area of external resorption, or represent a site of iatrogenic damage secondary to a history of surgical intervention. Tooth 32 has a poor prognosis.
Axial views of anterior mandible
These axial cross-sectional images demonstrate the concentric expansion of the buccal aspect of the alveolar process within the left anterior mandible. This pattern of expansion suggests the presence of a benign neoplastic process.
Buccolingual views of anterior 3rd quadrant
These buccolingual cross-sectional images demonstrate the heterogeneous pattern of granular bone formation within the exophytic lesion along the buccal aspect of the left anterior mandible. The underlying trabecular bone appears normal.
Periodontal bone loss on teeth 33 and 34
Teeth 33 and 34 demonstrate moderate horizontal periodontal bone loss.
4. Caries on teeth 35 and 36
The distal aspect of tooth 35, and the mesial and distal aspects of tooth 36, exhibit carious decay.
Periodontal bone loss on teeth 35 and 36
Teeth 35 and 36 exhibit moderate horizontal periodontal bone loss. Circumferential periodontal ligament space widening around the roots of tooth 36 suggests the presence of clinical mobility.