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Impacted / delayed / malpositioned / extra teeth
Region of interest
Left Maxilla (22-26)
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1. Ossifying fibroma in left maxilla
There is a well-defined, mixed radiolucent/radiopaque lesion located within the left maxilla, which extends from the mesial aspect of the developing tooth 26 to the distal aspect of the developing tooth 22, and from the alveolar crest to the overlying sinus floor. The periphery of this entity is fairly well-demarcated, with a discernable boundary between normal and abnormal bone. The internal structure is composed of scattered foci of granular and amorphous bone haphazardly organized within a radiolucent background.
This entity exhibits a concentric growth pattern about a definite epicenter, and has caused displacement of the developing teeth 23, 24, and 25 in a superior, mesiobuccal, and distopalatal direction, respectively. No signs of root resorption are evident, despite this finding. The buccal and palatal surfaces of the alveolar process are expanded, and the buccal and palatal cortical plates appear thinned, but remain mostly intact. The floor of the left maxillary sinus also appears focally elevated, but intact.
These findings suggest the presence of a juvenile ossifying fibroma. Histopathologic correlation is recommended to substantiate this interpretation.
2. Adenoid hyperplasia
The pharyngeal tonsils are enlarged, which is an appearance consistent with adenoid hyperplasia. In a pediatric patient, this represents an incidental finding with no clinical significance.
3. Arrested pneumatization of the sphenoid sinus
There is a well-defined, delicately low-density region located within the left sphenoid body. There are no effects on the surrounding structures. These findings are consistent with arrested pneumatization of the sphenoid sinus, which is a non-significant finding.