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Temporomandibular joints (TMJ)
Region of interest
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1. Unfilled MB2 canal in tooth 26
The existing obturation in the mesiobuccal root of tooth 26 is buccally positioned, which suggests that an unfilled second canal is present in the root (MB2). However, the periapical periodontal ligament space of the mesiobuccal root of tooth 26 appears normal, which suggests that this may represent a non-significant incidental finding. The periapical bone associated with the distobuccal and palatal roots also appears normal. There is no evidence of a root fracture.
Axial views of tooth 26
These axial cross-sectional images demonstrate the normal appearance of the alveolar bone surrounding the roots of tooth 26. There is no evidence of a fracture. The buccally positioned obturation within the mesiobuccal root suggests an unfilled MB2 canal is present.
Buccolingual views of tooth 26
These buccolingual cross-sectional images demonstrate the intact buccal and palatal cortical plates adjacent to the roots of tooth 26. No signs of persistent periapical pathology are present.
Mesiodistal views of tooth 26
These mesiodistal cross-sectional images demonstrate the intact alveolar bone on the mesial and distal surfaces of the roots of tooth 26. The periapical areas of the roots appear normal, and the sinus floor is intact. There is no evidence of antral inflammation.
Severe degenerative joint disease in the left TMJ
Osteophytes, cortical erosions, and extensive subchondral sclerosis are present within the mandibular and temporal components of the left temporomandibular joint. The joint space is reduced in caliber. These findings reflect the presence of severe degenerative joint disease.
Normal right TMJ in mandibular closed position
In the mandibular closed position, the right condylar head is centrally positioned in the glenoid fossa. This is normal. No osseous degeneration is present.
Restricted translation in left TMJ in mandibular open position
In the mandibular open position, the left condylar head does not exhibit any significant evidence of translation along the articular eminence. This limitation of condylar mobility is likely secondary to the extensive osteophytes within the mandibular and temporal components of the joint.
Normal right TMJ in mandibular open position
In the mandibular open position, the right condylar head translates to a point slightly posterior to the crest of the articular eminence. This is within the range of normal condylar motion.
Coronal views of left TMJ
These coronal cross-sectional images demonstrate extensive osteophyte formation along the medial and lateral aspects of the glenoid fossa, as well as subchondral sclerosis involving the condyle and temporal components of the joint.
Sagittal views of left TMJ
These sagittal cross-sectional images demonstrate extensive osteophyte formation, subchondral sclerosis, and cortical erosions involving the left temporomandibular joint. Note the prominent osteophyte involving the anterior aspect of the glenoid fossa, which is a probable source of restricted left-sided condylar translation.
2. Lingual mandibular tori
Lingual tori composed of cortical bone are present along the alveolar process of the right and left mandible adjacent to the canine-premolar regions. This is a non-significant incidental finding.
3. Concha bullosa
The right middle nasal concha contains air. This represents a concha bullosa and is an incidental finding with no clinical significance.
4. Ethmoid sinus mucositis
The right ethmoid cells are partially opacified. This is reflective of the presence of ethmoid sinus mucositis.
5. Mild cervical degenerative joint disease
Osteophytes are present in the articular regions of the atlas and dens of the cervical vertebrae. This is a common incidental finding with no clinical significance that is suggestive of mild cervical degenerative joint disease.