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Case 141664

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Referral category

Disease / syndrome / tumor / condition

Region of interest

left posterior mandible

Referral reason

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1 Files Info

Canaray 141664

1. Marsupialized dentigerous cyst associated with tooth 38

A well-defined, corticated, unilocular cystic entity is continuous with the follicle around the crown of the impacted tooth 38. This entity is associated with the cementoenamel junction of tooth 38. The cyst has extended through the superior border of the alveolar crest distal to tooth 37, and has caused mild resorption at the distal root apex of tooth 37. The internal periphery of the cystic entity demonstrates a granular bone pattern, which suggests the presence of marsupialization. Tooth 38 has been inferiorly and distally displaced. The roots of tooth 38 exhibit hypercementosis. These radiographic features are most consistent with a dentigerous cyst associated with the impacted tooth 38, which is partially marsupialized.

Mesiodistal views of the cystic lesion without nerve tracking

These mesiodistal cross-sectional images demonstrate the inferior passage of the mandibular nerve canal along the inferior surface of the cyst as well as the intact superior border of the nerve canal. The nerve appears inferiorly displaced. Note the granular bone formation at the periphery of the cyst, which represents marsupialization and partial healing.

Buccolingual views of the cystic lesion without nerve tracking

These buccolingual cross-sectional images demonstrate the inferior displacement of the mandibular canal. The superior border of the nerve canal appears to be intact.

Left mandibular nerve apical to tooth 38

The left mandibular nerve courses apical to the mesial distal root apices of the horizontally impacted tooth 38. No nerve compression is present. The roots of the tooth are superiorly dilacerated. The periodontal ligament space is visible around the entire root circumference, which suggests this tooth is not ankylosed. The tooth has been displaced inferiorly and distally due to the dentigerous cyst associated with the crown of the tooth.

Axial views of tooth 38

These axial cross sectional images of tooth 38 demonstrate the apical passage of the nerve relative to the root of tooth 38.

Mesiodistal views of tooth 38

These mesiodistal cross-sectional images demonstrate the horizontal orientation of tooth 38 relative to the long-axis of tooth 37, and the cystic appearance of its residual follicle. The left mandibular nerve canal passes apically to the dilacerated roots of the tooth.

2. Mild external root resorption on tooth 37D

Mild external resorption is present on the distal surface of the apical third of the distal root of tooth 37 due to the proximity of the dentigerous cyst associated with the impacted tooth 38. Tooth 37 appears normal otherwise.

Normal tooth 36

Tooth 36 is partially captured in this image volume and appears normal radiographically. There are no signs of root resorption on the distal root of this tooth. The dentigerous cyst extends to the adjacent periapical area of the distal root of tooth 36.

3. Left palatine tonsilloliths

Tonsilloliths are present in the left palatine tonsil. This is an incidental finding with no clinical significance.