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Case 124086

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Referral category

Facial or muscle pain / paralysis / unusual sensations

Region of interest

Q4

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Canaray 124086

1. Fibrous dysplasia in right mandible with simple bone cyst formation

There is a moderately well-defined, non-corticated, mixed radiolucent/radiopaque entity located within the posterior right mandible, apical to teeth 44, 45, 46, and 47, and the edentulous site 48. This entity exhibits a heterogeneous internal structure, with regions of fine, granular bone intermixed with radiolucent locules. This entity scallops around the roots of the posterior right mandibular teeth, but there is no evidence of root resorption or tooth displacement. Their lamina durae remain mostly intact.

The right inferior alveolar nerve canal courses through this this entity, and appears mildly displaced in a buccal direction. There is no significant evidence of nerve compression. This entity has caused an irregularly shaped enlargement of the posterior right mandible, without an identifiable epicenter of growth.

In comparison to the previous study dated 2013-01-11 (case ID: 25584), the radiolucent regions of this entity appear relatively larger with better defined, thinly corticated margins that scallop along the endosteal surfaces of the bone. The contiguous lingual cortical plate appears significantly thinned in the present scan, but remains fully intact. These findings suggest the concomitant presence of simple bone cyst formation, which is an occasional observation in fibrous dysplasia cases.

Normal right TMJ

The osseous structures of the right temporomandibular joint are partially captured in this imaging volume. Based on what can be visualized, these structures appear normal radiographically. The articular cortices are intact, and the trabecular bone exhibits a normal density and organization. There is no significant evidence of degenerative disease. The right coronoid process also appears within the range of normal. There is no evidence of a hard tissue etiology leading to the reported limitation in mandibular opening. The articular discs cannot be directly assessed in CBCT imaging.

2. Slightly dysplastic bone in right mandibular ramus

There is a moderately well-defined, relatively smaller focus of low-density granular bone located within the body of the right mandibular ramus, just anterior to the right inferior alveolar nerve canal. There are no effects on the surrounding structures. These findings suggest another focal region of dysplastic bone, which does not require treatment. The remainder of the right mandibular ramus appear within the range of normal.

Generalized periodontal bone loss

There is generalized mild to moderate horizontal bone loss involving the imaged dentition. Calculus deposits are present between the mandibular incisors.

3. Radicular defect on tooth 17D

There is a well-defined, concave defect located along the distal surface of the coronal half of the distobuccal root of tooth 17, which encroaches its distobuccal root canal. Localized periradicular bone loss is observed adjacent to this defect. Based on what can be visualized, there are no radiographic signs of periapical pathology. These findings could suggest the presence of external resorption or a history of iatrogenic damage. Clinical correlation is recommended to assess if this tooth could be a contributing source of the patient's symptoms.

4. Possible caries on teeth 16, 17

Caries may be present along the distal aspect of tooth 16 and the mesial aspect of tooth 17. Clinical examination and intraoral radiography may aid in substantiating this interpretation.

5. Possible caries on teeth 26, 27

Caries may be present along the distal aspect of tooth 26 and the mesial aspect of tooth 27. Clinical examination and intraoral radiography may aid in substantiating this interpretation.

6. Possible caries on tooth 47

Caries may be present along the occlusal surface of the crown of tooth 47. Clinical correlation is recommended. No signs of endodontic pathology are present.

7. Right palatine tonsillolith

A tonsillolith is present in the right palatine tonsil. This is an incidental finding with no significance because tonsilloliths exfoliate spontaneously.

8. Mild mucosal thickening in right maxillary sinus

Mild mucosal thickening is evident in the right maxillary sinus, which is suggestive of mucositis. This is a common incidental finding with no clinical significance.

9. Calcified stylohyoid ligament

The right stylohyoid ligament is partially calcified. This is an incidental finding with no significance.