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Referral details

Case 165650

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Referral category

Impacted / delayed / malpositioned / extra teeth

Region of interest

Anterior Maxilla

Referral reason

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2 Files Info

Canaray 165650

1. Incomplete gemination of tooth 22

Tooth 22 exhibits incomplete gemination, resulting in fused mesial (22M) and distal (22D) segments that are connected by a central isthmus. The crown of the mesial segment exhibits typical lateral incisor morphology, however, the root curves mesially and exhibits a cleft at the mesial surface of the coronal third of the root. The pulp canals within the mesial and distal segments of tooth 22 communicate through a central isthmus through the apical two thirds of the roots, which precludes separation of the two segments. The roots of the mesial and distal segments of tooth 22 are approximately 75% formed and the periodontal ligament space is visible around the entire root circumference, which suggests this tooth is not ankylosed.

Axial views of teeth 22M and 22D

These axial cross-sectional images demonstrate communication between the root canal systems of teeth 22M and 22D. The periodontal ligament space is visible around the root circumference, and there is no indication of ankylosis.

Vertically oriented developing tooth 23

The unerupted tooth 23 is partially captured in this imaging volume. The crown of the tooth is positioned distobuccal to the developing root apex of tooth 22D. Inadequate mesiodistal space may be present between teeth 22D and tooth 24 once it erupts to accommodate the crown of tooth 23. No root resorption is present on the adjacent permanent teeth, but teeth 22M+D and 63 are displaced. The residual follicle surrounding the crown appears normal. Based on what can be visualized, there is no evidence of ankylosis.

Severe physiologic resorption + displaced tooth 63

Tooth 63 exhibits severe root resorption on the mesiopalatal surface of the coronal third of the root. The root integrity has been significantly compromised, which increases the risk of fracture. The root apex appears displaced in a buccal direction. Tooth 63 may require extraction in order to facilitate the eruption of tooth 23. The crown of tooth 23 is positioned palatal in the apical third of the root of tooth 63.

Displaced tooth 22M + 22D

Tooth 22M and 22D appears mesially displaced due to the close proximity to the unerupted tooth 23. No resorption is evident. The crown of tooth 23 is positioned distobuccal to the developing root apex of tooth 22D.

Rotated tooth 21

The buccal surface of the crown of the developing tooth 21 is rotated mesially by approximately 20 degrees. The crown of tooth 22M is positioned distal to the crown of tooth 21. No resorption is evident at tooth 21.

Axial views of the anterior 2nd quadrant

These axial cross-sectional images demonstrate incomplete gemination of tooth 22. Teeth 22M+22D and 63 are displaced. Tooth 21 is rotated. There is no evidence of root resorption in the remaining permanent teeth captured in this imaging volume.

2. Mild mucositis of the left maxillary sinus

The left maxillary sinus exhibits mild mucositis, which represents an incidental finding with no clinical significance.