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Case 129768

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Referral category

Dental implants

Region of interest

46/47-,36/37

Referral reason

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1 Files Info

Canaray 129768

1. Rarefying osteitis on tooth 26MB

There is rarefying osteitis located periapical to the mesiobuccal root of the endodontically-treated tooth 26. The endodontic obturation in this root is buccally positioned and extends beyond its radiographic apex. An unfilled and heavily calcified MB2 canal may be present. The buccal cortex overlying this region appears thinned and partially dehiscent, which suggests the presence of a draining sinus tract. The remaining periapical and periradicular bone appears normal, and there are no signs of root perforation or root fracture.

These findings suggest the presence of persistent endodontic pathology in tooth 26.

2. Rarefying osteitis on tooth 35

There is rarefying osteitis located periapical to the endodontically-treated tooth 35. The existing obturation in this tooth appears centrally positioned, but ends slightly short of the radiographic apex. The remaining periradicular bone appears normal, and there are no signs of root perforation or fracture. These findings suggest the presence of persistent endodontic pathology.

3. Furcal bone loss in tooth 48

Furcal bone loss is evident in tooth 48, which extends from the furcal floor to the apical thirds of its roots. The buccal cortex overlying this region appears partially dehiscent, which suggests the presence of a sinus tract. The existing obturation in the distal root of this tooth appears centrally positioned and extends to the root apex, while the obturations of its mesiobuccal and mesiolingual canals end slightly short of their radiographic apices. There are no radiographic signs of root perforation or uninstrumented primary canals. This pattern of bone loss could suggest the possibility of a non-displaced furcal fracture in tooth 48. The periapical bone surrounding the roots of this tooth appears relatively normal.

Generalized periodontal bone loss

There is generalized mild to moderate horizontal bone loss involving the imaged dentition.

5. Moderate mucositis in right maxillary sinus

Moderate mucosal thickening is present on the floor of the right maxillary sinus. This is an incidental finding that is suggestive of mucositis.

4. Acute inflammatory changes in the left maxillary sinus

The left maxillary sinus exhibits moderate mucosal thickening with the concurrent presence of an air-fluid level. These findings could suggest acute inflammatory changes involving the soft tissue lining of the maxillary sinus, which could infer the possibility of sinusitis. It should be noted that sinusitis is a clinical diagnosis, and radiologic findings are often non-specific. A referral to an ENT specialist may be considered if the patient exhibits any relevant signs and symptoms suggestive of recurrent sinusitis.

6. Soft tissue mass overlying right side of uvula

A well-defined, elongated soft tissue mass is evident along the right dorsal surface of the uvula, which extends from the posterior aspect of the right nasal choana to the inferior third of the uvula. These findings could suggest the presence of a prolapsed antrochoanal polyp. However, soft tissue masses are non-specific on CBCT imaging, and further investigation by an ENT specialist is recommended.

7. Left palatine tonsillolith

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