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Referral details

Case 15360

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Referral category

Facial or muscle pain / paralysis / unusual sensations

Region of interest

Right mandible

Referral reason

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Canaray 15360

1. Right mandibular nerve through furcation of tooth 48: High risk of jaw fracture or nerve damage

A mesiodistal furcation is present in tooth 48, and the right mandibular nerve courses through this furcation. The nerve is mildly compressed by the roots of tooth 48.

Of particular concern is the inferior displacement of the root of tooth 48 to the inferior border of the right mandibular body. The risk of jaw fracture or nerve damage during tooth removal is high.

Axial views of IAN passage through tooth 48

These axial cross sectional images demonstrate the passage of the right mandibular nerve through the mesiodistal furcation of tooth 48.

1. Odontogenic keratocyst in posterior left mandible

A well defined bi-lobed cystic entity is developing in the region coronal to tooth 48. This cystic entity has displaced tooth 48 inferiorly, and has extended into the right ramus. The entity is approximately 33 mm tall, and has also displaced the right mandibular nerve inferiorly. The degree of buccolingual expansion of the mandible is much lower than the mesiodistal or superior-inferior extents of the entity, which suggests that it likely represents an odontogenic keratocyst.

2. Rarefying osteitis on tooth 26MB

The mesiobuccal root of tooth 26 exhibits periapical rarefying osteitis.