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Referral details

Case 173622

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Referral category

Troublesome / painful / cracked tooth (Endodontic)

Region of interest

11, 12, 13

Referral reason

[Only visible to logged-in users]

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Canaray 173622

1. Large bone defect in the anterior first quadrant

A prominent bone defect is present in the anterior first quadrant in the region apical to implant 12. This defect extends from the maxillary incisive canal mesially to the periapical region of tooth 13 distally, and extends superiorly through the nasal floor. Dehiscences are present in the buccal and lingual cortical plates. The lesion surrounds the apex of the implant at site 12. The overall radiographic appearance is suggestive of a large marsupialized post-surgical defect. Teeth 11 and 13 do not appear to be affected by the lesion, and are not contributory factors to the formation of the lesion.

Normal implant 12

The distal surface of the apical third and the apex of the implant at site 12 appears to lack bone coverage. The remainder of the implant shows evidence of osseointegration and there is no evidence of intraosseous pathology around the implant.

Normal post-treatment appearance of tooth 11

Tooth 11 exhibits a history of endodontic treatment. 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 unobturated canals are present. The endodontic treatment appears successful. This tooth is unaffected by the bony defect in the anterior first quadrant.

Normal post-treatment appearance of tooth 13

Tooth 13 exhibits a history of endodontic treatment. 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 unobturated canals are present, but the existing obturation ends short of the apex. There is no evidence of root fracture. Tooth 13 is not affected by the prominent bone defect in the anterior first quadrant.

2. Blunted root apex of tooth 21

The root apex of tooth 21 appears blunted, which suggests a history of mild apical root resorption. Tooth 21 appears normal, otherwise. No periapical pathology is present. There is no evidence of root fracture.

3. Blunted root apex on tooth 14P

The palatal root apex of tooth 14 exhibits a slightly shortened and blunted appearance, which suggests a history of mild apical root resorption at the palatal root. No signs of endodontic or periradicular pathology are present.

4. Mild mucosal thickening of the right maxillary sinus

Mild mucosal thickening is present in the right maxillary sinus. This is an incidental finding with no clinical significance.