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Troublesome / painful / cracked tooth (Endodontic)
Region of interest
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1. Periosteal bone formation adjacent to tooth 46MB
A localized zone of periosteal bone formation is present in the region adjacent to the buccal surface of the mesial root of tooth 46. This periosteal bone formation appears to be secondary to a crack in the buccal surface of the mesial root of tooth 46. Tooth 45 is not the source of the lesion.
2. Possible vertical fracture at tooth 46MB
The buccal cortical plate has been lost in the region adjacent to the mesiobuccal surface of the mesial root of tooth 46. Localized periosteal bone formation has occurred in this region. This radiographic appearance is suggestive of the presence of a vertical fracture in the mesiobuccal aspect of the mesial root of tooth 46. No unobturated canals are visible in tooth 46. The distal root of the tooth appears normal radiographically.
The superior cortex of the inferior alveolar nerve canal is separated from the mesial and distal root apices of tooth 46 by 4.8mm and 4.9mm, respectively.
3. Healing post-treatment appearance of tooth 45
The apical periodontal ligament space of tooth 45 is slightly widened. Endodontic sealer has been extruded through the apical foramen of the tooth. Low-density granular bone is present in the periapical region of tooth 45. This bone represents a healing post-treatment pattern. The bone surrounding the remaining root surfaces of tooth 45 appears normal. No signs of root fracture are radiographically evident.
The superior cortex of the inferior alveolar nerve canal is separated from the root apex of tooth 45 by 2.4mm.
4. Rarefying osteitis at tooth 44
Tooth 44 exhibits periapical rarefying osteitis. The endodontic obturation of the tooth appears to be centrally positioned within the root, which suggests that no additional primary canals are present. The bone surrounding the coronal half of the root of tooth 44 appears normal radiographically, which suggests that the tooth is not fractured. Therefore, this radiographic appearance is suggestive of a persistent endodontic lesion or a healing post-treatment appearance of tooth 44.
5. Dense bone island mesial to tooth 17
A dense bone island is present in the alveolar bone just mesial to tooth 17. This dense bone island demonstrates no effects on its surrounding structures. This is a non-significant incidental finding.
Periodontal bone loss
Moderate periodontal bone loss is present in the right posterior maxilla and mandible.