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Troublesome / painful / cracked tooth (Endodontic)
Region of interest
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1. Florid osseous dysplasia with simple bone cysts in left mandible
A well-defined, corticated radiolucency is present within the periapical regions of teeth 31, 32, 33, and 34, which has caused thinning of the overlying buccal and lingual cortical plates. A radiolucency is also evident apical to the mesial aspect of tooth 37. Multiple sclerotic radiopacities are evident adjacent to the root apices of the mandibular teeth captured in this imaging volume. This appearance reflects the presence of florid osseous dysplasia with simple bone cysts in the left mandible. Note that the mandibular body and posterior mandible are incompletely captured in this imaging volume, and the full extent of mandibular involvement cannot be determined.
Axial views of mid-3rd quadrant
These axial cross-sectional images demonstrate thinning of the buccal and lingual cortical plates within the anterior mandible, as well as mild buccolingual expansion. This is a common feature of simple bone cysts. A second simple bone cyst is evident around the apical aspect of tooth 37.
Mesiodistal views of anterior 3rd quadrant
These mesiodistal cross-sectional images demonstrate the presence of sclerotic radiopaque foci around the periapical regions of the teeth in the left anterior mandible. This reflects the presence of florid osseous dysplasia.
Mesiodistal views of mid-3rd quadrant
These mesiodistal cross-sectional images demonstrate sclerotic radiopacities around the apical aspects of teeth 34 and 35. The simple bone cyst that is centered within the left anterior mandible appears to extend to the mesial aspect of the root of tooth 35.
2. Draining sinus tract associated with tooth 35
While the simple bone cyst within the left anterior mandible appears to extend to the mesial aspect of the root of tooth 35, a distinct radiolucency is evident within the periapical region of this tooth. This periapical radiolucency tracks distally and occlusally, and the alveolar crest is lost within the edentulous 36 site. This appearance suggests that tooth 35 may be devitalized. Note that the presence of sclerotic dysplastic bone formation within the apical aspect of tooth 35 may impede osseous healing in this area following endodontic treatment. The region should be monitored clinically and radiographically to ensure this area of periapical pathology does not evolve into osteomyelitis.
Tooth 35 contains a single, centrally positioned root canal system.