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Troublesome / painful / cracked tooth (Endodontic)
Region of interest
12, 11, 22
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1. Possible marsupialized cystic lesion of maxillary incisive canal
The maxillary incisive canal is irregularly widened. A defect extends from the canal to the surface of the alveolar process in the periapical region of tooth 11. This radiographic appearance may represent a marsupialized cystic lesion, such as a marsupialized nasopalatine duct cyst, or may be a post-surgical appearance secondary to the presence of a prior large periapical endodontic lesion originating at tooth 11 or 12. The bone in the surrounding region is sclerotic, and exhibits a post-surgical appearance. The corticated periphery of the defect in the periapical region of tooth 11 suggests that the defect will not spontaneously heal.
2. Secondarily affected tooth 12
The radiolucent defect that is associated with the maxillary incisive canal extends around the palatal surface of the root apex of tooth 12. No pathology originates at the apical foramen of tooth 12, which suggests that the endodontic treatment of the tooth has been successful and that the tooth has been secondarily affected by the radiolucent lesion. No signs of root fracture present at tooth 12.
3. Secondarily affected tooth 11
The periapical periodontal ligament space of tooth 11 is slightly widened. This most likely represents a healing post-treatment appearance. The bone surrounding the root surfaces of tooth 11 appears normal otherwise, which suggests that the endodontic treatment of the tooth has been successful. The large periapical lesion that originates at the maxillary incisive canal appears to have secondarily affected the palatal surface of the root apex of tooth 11, but has not had any other effect upon the tooth. No signs of root fracture present in tooth 11.
Normal tooth 22
Tooth 22 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 root fracture are present