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Case 145465

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Referral category

Disease / syndrome / tumor / condition

Region of interest

4th quad

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Canaray 145465

1. Benign odontogenic cyst or tumor in right mandible

A well-defined, corticated, unilocular radiolucency is present in the right mandibular alveolar process and body, which extends between the apical aspects of tooth 42 and 46 and from the midroot level of teeth 43/44 to the inferior mandibular cortex. The contiguous buccal and lingual cortical plates remain intact and are minimally expanded. Mild external root resorption is noted on tooth 44, and the root apices of teeth 43, 44, and 45 appear to be lingually displaced. The right mandibular nerve canal is partially effaced by this radiolucency.

These radiographic findings are consistent with a benign odontogenic cyst or cystic neoplasm. The extent of the lesion suggests an endodontic source is unlikely. The possibility of an odontogenic keratocyst should be considered. Biopsy and histopathologic confirmation are required for a definitive diagnosis.

Orthogonal views of cystic lesion in right mandible

These orthogonal cross-sectional images demonstrate the absence of significant buccolingual expansion associated with the cystic radiolucency in the right mandible. The periphery of this lesion exhibits a broad scalloping appearance. These findings both support the interpretation of an odontogenic keratocyst. Note the partial effacement of the cortex of the right mandibular nerve canal in the region of the right mental foramen.

2. Retained root fragment at site 28

A retained root fragment is evident at the crestal aspect of the edentulous site 28, which is partially captured in this imaging volume. Extraction is indicated.

3. Vertical periodontal bone loss + calculus on tooth 37D

The distal aspect of tooth 37 exhibits vertical periodontal bone loss extending to the midroot level. Gross calculus deposition is evident on the coronal third of the root.

4. Coronal fracture on tooth 36Li

The lingual aspect of the crown of tooth 36 is fractured. No significant signs of endodontic pathology are noted.

5. Retained root fragment at site 35

A root fragment is retained within the crestal soft tissues at site 35. Removal is indicated.

Periodontal bone loss

Mild horizontal periodontal bone loss is present in the mandibular incisor and molar regions.