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Troublesome / painful / cracked tooth (Endodontic)
Region of interest
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1. Retained root of tooth 12
The root of tooth 12 is retained, and exhibits a small focus of periapical rarefying osteitis. No unfilled canals are visible within the tooth. No signs of root fracture are present. Extraction of this retained root appears to be indicated.
2. Periradicular bone loss at tooth 11
Tooth 11 exhibits a broad zone of periradicular bone loss, which is particularly prominent on its mesial surface. This bone loss extends from the periapical region of the tooth to the alveolar crest and has extended through the buccal cortical plate adjacent to the apical half of the root. This may represent a long-standing draining periapical lesion or may be a sign of a fracture within the root. Tooth 11 has a high crown to root ratio, which negatively affects its prognosis.
Normal tooth 21
Tooth 21 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.
3. Expansile soft tissue lesion in left hard palate
An expansile soft tissue lesion with a cystic shape is present in the left hard palate. This lesion communicates with a defect in the alveolar process at site 24. If tooth 24 was recently extracted, it is possible that the palatal lesion is secondary to a drainage of a former endodontic lesion at site 24. If tooth 24 has been absent for a long period of time, the palatal lesion may have induced bone loss in the maxillary alveolar process at site 24. Overall, the radiographic appearance is most suggestive of a recent extraction at site 24, and a large palatal swelling that originated at site 24. If a recent extraction has not been performed at site 24, biopsy of the soft tissue of the left hard palate is indicated to determine whether a benign salivary gland tumor is present.