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Case 173337

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Referral category

Disease / syndrome / tumor / condition

Region of interest

46, [scan full mandible]

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[Only visible to logged-in users]

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Canaray 173337

1. Osteomyelitis in right posterior mandible

An extensive area of lytic bone loss surrounded by diffuse sclerosis is present within the right posterior mandible, which extends between the canine and molar regions. Multiple osseous sequestra are evident within both the buccal cortical plate and within the trabecular bone. The mesial root of tooth 47 is retained within the alveolar process. The cortex of the right mandibular nerve canal is partially effaced apical to tooth 46 and within the mental foramen region by this lytic bone loss.

This appearance is consistent with the presence of osteomyelitis. Extraction of the retained mesial root of tooth 47 is indicated, as is vitality testing of teeth 43, 44, 45, and 46. Regional debridement will be required in addition to medical management.

Axial views of posterior 4th quadrant

These axial cross-sectional images demonstrate extensive sequestration of the buccal cortical plate within the right posterior mandible. Sequestration within the trabecular bone is also evident.

Mesiodistal views of posterior 4th quadrant

These mesiodistal cross-sectional images demonstrate lytic bone loss extending between tooth 43 and site 47, as well as the retained mesial root fragment at site 47. Apical periodontal ligament space widening is noted on teeth 43 and 44, and extensive periradicular bone loss involves teeth 44, 45, and 46.

Buccolingual views of posterior 4th quadrant

These buccolingual cross-sectional images demonstrate extensive sequestration of the buccal cortical plate of the right posterior mandible. Note the course of the right mandibular nerve canal relative to the region of lytic bone loss and osseous sequestra.

2. Retained restorative material at site 37

A small fragment of retained radiopaque restorative material is present in the alveolar crest at site 37. This is a non-significant incidental finding.

Periodontal bone loss on mandibular incisors

Mild horizontal periodontal bone loss is present on the mandibular incisors.

Impacted tooth 28

A small amount of the impacted tooth 28 is captured in this imaging volume. No further comments can be made based on this limited field of view.

3. Mild cervical degenerative joint disease

Small osteophytes are present in the articular regions of the atlas and dens of the cervical vertebrae. This is a common incidental finding with no clinical significance that is suggestive of mild cervical degenerative joint disease.