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Troublesome / painful / cracked tooth (Endodontic)
Region of interest
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1. Gas bubbles in buccal soft tissue: medical or oral surgery referral indicated
A large number of gas bubbles and spaces are present in the soft tissue overlying the posterior right mandible. This is a very unusual radiographic appearance, and may be a sign of a fascial space infection. An immediate referral to the patient's physician or an oral surgeon for medical imaging or further follow-up is recommended to determine the source of this soft tissue pathology, and to initiate treatment.
Normal tooth 47
Tooth 47 appears normal radiographically. The periodontal ligament space is of uniform width around the entire root circumference of the tooth and the lamina dura is intact. No endodontic or periradicular pathology is radiographically evident. No signs of root fracture are present. The mesial and distal root apices of tooth 47 are separated from the superior border of the right mandibular nerve canal by 5.9mm and 5.1mm, respectively. Tooth 47 does not appear to be the source of the patient's symptoms.
Normal tooth 46
Tooth 46 appears normal radiographically. No signs of endodontic or periradicular pathology are present. The periodontal ligament space is of uniform width around the tooth and the lamina dura is intact. No signs of fracture are present, radiographically. The superior cortex of the right inferior alveolar nerve canal is separated from the mesial and distal root apices of tooth 46 by 7.7mm and 7.9mm, respectively. This tooth is unlikely to be the source of the patient's symptoms.