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Referral details

Case 171135

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Referral category

Wisdom Teeth

Region of interest

13, 28

Referral reason

[Only visible to logged-in users]

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Canaray 171135

Mesioangularly impacted tooth 13: no evidence of supernumerary tooth

The crown of the mesioangularly impacted tooth 13 is positioned at the distopalatal surface of the middle third of the root of tooth 12. There is no evidence of a supernumerary tooth in the anterior first quadrant. No root resorption is present on the adjacent permanent teeth. The mesial curve of the palatal root of tooth 14 is a contributing source of impaction of tooth 13. The root of tooth 13 is fully formed and exhibits a prominent apical curve. The root apex is positioned at the junction of the anterior floor of the right maxillary sinus and the lateral wall of the right nasal fossa. The residual follicle surrounding the crown appears hyperplastic. The periodontal ligament space is visible around the entire root circumference, which suggests that ankylosis is not present. The crown of tooth 13 can be surgically accessed from the palatal aspect of the alveolar process, at the middle third of the root of tooth 12.

Axial views of tooth 13

These axial cross-sectional images demonstrate that the periodontal ligament space lining the root circumference of tooth 13 is visualized, which suggests the absence of ankylosis. The residual follicle surrounding the crown of tooth 13 appears hyperplastic.

Normal tooth 11

Tooth 11 is unaffected by the impacted tooth 13. The crown of tooth 13 is positioned distopalatal to the middle third of the root of tooth 11. No resorption is evident at tooth 11.

Normal tooth 12

Tooth 12 is unaffected by the impacted tooth 13. The crown of tooth 13 is positioned at the distopalatal surface of the middle third of the root of tooth 12. No resorption is present on tooth 12.

Mesially curved root of tooth 14P: probable cause of impaction of tooth 13

The apical half of the palatal root of tooth 14 appears curved in a mesial direction, which is the probable source of impaction of tooth 13. Tooth 14 appears otherwise normal, and there are no signs of root resorption due to its close proximity to the impacted tooth 13. The middle third of the root of tooth 13 is positioned mesial to the palatal root apex of tooth 14.

Axial views of the anterior first quadrant

These axial cross-sectional images demonstrate the position of the impacted tooth 13 relative to the roots of teeth 11, 12, and 14. The mesial curve of the palatal root of tooth 14 is the probable source of impaction of tooth 13. There is no evidence of resorption in any of the adjacent permanent teeth. A supernumerary tooth is not evident in the anterior first quadrant.

Malformed roots of tooth 28

The crown of the vertically oriented tooth 28 is positioned distal to the middle third of the distobuccal root and distobuccal to the middle third of the palatal root of tooth 27. Root development has not yet begun. Multiple sites of ectopic enamel formation are present in this tooth, however, which will likely form enamel pearls. No resorption is present at the distal aspect of tooth 27. The residual follicle surrounding the crown appears normal and no signs of ankylosis are present. The floor of the adjacent maxillary sinus appears thinned and slightly displaced, but remains intact.

Axial views of posterior 2nd quadrant

These axial cross-sectional images demonstrate the distal position of the crown of tooth 28 relative to the crown of tooth 27. There are no signs of ankylosis, and no resorption is noted on tooth 27.

Mesiodistal views of posterior 2nd quadrant

These mesiodistal cross-sectional images demonstrate the vertical orientation of tooth 28 relative to the adjacent tooth 27. No signs of resorption are evident on tooth 27.

1. Opacified right maxillary sinus

The right maxillary sinus is partially captured in this imaging volume. The visible portion of the sinus appears completely opacified, which could suggest mucositis or sinusitis. No further comments can be made based on this limited field of view.

2. Sinusitis of left maxillary sinus

The portion of the left maxillary sinus captured in this imaging volume is almost completely opacified with concurrent air bubble formation. These findings suggest inflammatory changes involving the soft tissue lining of the left maxillary sinus, which could infer the possibility of sinusitis. Referral to an ENT specialist may be considered if the patient exhibits any relevant signs and symptoms.