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Troublesome / painful / cracked tooth (Endodontic)
Region of interest
Q3 anterior mandible
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1. Ameloblastoma in anterior mandible
A well-defined, corticated, multilocular radiolucency is present within the anterior mandible, which extends from the edentulous 42 region to the 33/34 interproximal area and from the alveolar crest to the level of the lingual mandibular foramen. The loculations are small and separated by prominent curvilinear septae. The buccal and lingual cortical plates are thinned, and buccal expansion is noted.
This radiographic appearance reflects the presence of a benign odontogenic neoplasm. An ameloblastoma is the most likely interpretation. Biopsy and histopathologic evaluation is indicated.
Axial views of anterior mandible
These axial cross-sectional images demonstrate the extent of the ameloblastoma from the edentulous 42 area to the 33/34 interproximal region. Note the thinned and expanded cortical plates.
Mesiodistal views of anterior mandible
These mesiodistal cross-sectional images demonstrate multiple small loculations within the anterior mandible, which are separated by prominent curvilinear septae. This appearance is highly suggestive of an ameloblastoma.
Buccolingual views of anterior mandible
These buccolingual cross-sectional images demonstrate thinning and dehiscence of the buccal and lingual cortical plates and of the alveolar crest within the anterior mandible. The mandibular body inferior to the lingual mandibular foramen exhibits a normal trabecular bone pattern.
Restorative treatment indicated on tooth 43
The crown of tooth 43 requires restorative treatment. The periradicular bone appears normal.
2. External resorption on tooth 33Bu
The buccal surface of tooth 33 exhibits external resorption involving the coronal half of the root. This area of resorption extends subcrestally, and the extent of the defect suggests it may not be amenable to treatment. The extension of the ameloblastoma around the root of tooth 33 and into the 33/34 interproximal area is evident.