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Troublesome / painful / cracked tooth (Endodontic)
Region of interest
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1. Odontogenic keratocyst in the posterior right mandible
A well-defined radiolucent entity comprised of two distinct lobes is present in the posterior right mandibular body and ramus. This entity has not caused significant buccolingual expansion of the alveolar process, but extends from the distal surface of tooth 46 to the coronoid notch. Dehiscences are present at the alveolar crest at sites 47 and 48, which suggests that the entity may be marsupialized. The inferior alveolar nerve canal has not been significantly affected by the entity and generally passes inferiorly to the lesion. However, the radiolucent lesion extends around the lateral aspect of the canal at the lingula. This radiographic appearance is suggestive of the presence of a large marsupialized odontogenic keratocyst.
Additional views of posterior loculation of the keratocyst
This panoramic reconstruction and cross sectional slices demonstrate the extension of the radiolucent lesion into the right mandibular ramus, as well as the absence of any significant buccolingual expansion of the ramus by the lesion. Note the loss of the anterior cortical border of the ramus in the region adjacent to the lesion.
Orthogonal measurements of lesion in posterior ramus
These orthogonal cross-sectional images demonstrate the lesion in the posterior ramus from various perspectives. The entity measures approximately 45.1mm mesiodistally, 9.3mm buccolingually and 25.4mm superior-inferiorly.
Additional views of loculation of keratocyst at site 46
The unilocular radiolucent cystic entity that is present at site 46 has not caused any buccolingual expansion of the alveolar process. The superior border of the entity extends through the alveolar crest, which suggests that the lesion has marsupialized. The tooth that is positioned mesially to the entity appears normal.
Orthogonal measurements of a loculation of keratocyst at site 46
These orthogonal cross-sectional images demonstrate the approximate dimensions of a loculation of the keratocyst at site 46.
2. Elongated right styloid process
The right styloid process is elongated. This is an incidental finding with no significance.
3. Mild mucositis of right maxillary sinus
The right maxillary sinus exhibits mild mucositis, which represents an incidental finding with no clinical significance.
4. Right palatine tonsilloliths
Tonsilloliths are present in the right palatine tonsil. This is an incidental finding with no clinical significance because tonsilloliths exfoliate spontaneously.