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Case 152962

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Disease / syndrome / tumor / condition

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quad 3

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Canaray 152962

1. Osteomyelitis in left posterior mandible

A broad zone of lytic bone loss is present within the left posterior mandibular alveolar process and body, which involves the edentulous 36/37 region. The alveolar crest is lost, and the buccal and lingual cortices are dehiscent and partially sequestered. Multiple sequestra are dispersed through the residual trabecular bone in this region. The left mandibular nerve canal is unaffected. These radiographic findings are consistent with the presence of osteomyelitis.

Mesiodistal views of posterior 3rd quadrant

These mesiodistal cross-sectional images demonstrate extensive bone loss at sites 36 and 37, which has resulted in loss of the alveolar crest, as well as the contiguous buccal and lingual cortical plates. Sequestra are evident within this area of lytic bone loss. Note that the cortex of the left mandibular nerve canal is preserved.

Periodontal bone loss on tooth 38

Tooth 38 exhibits moderate to severe periodontal bone loss. The area of osteomyelitis within the left posterior mandible extends to abut the roots of tooth 38, which suggests this tooth likely has a poor prognosis.

2. External resorption or iatrogenic damage to tooth 38M

A defect is present on the mesial surface of the mesial root of tooth 38 at the level of the apical third of the root. This may represent external resorption or iatrogenic damage.

Periodontal bone loss on teeth 34 and 35

Mild horizontal periodontal bone loss is present on tooth 34 and on the mesial aspect of tooth 35. Moderate to severe periodontal bone loss involves the distal aspect of tooth 35. The proximity of tooth 35 to the area of osteomyelitis in the left posterior mandible suggests the prognosis of this tooth is guarded.