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Case 176087

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Referral category

Disease / syndrome / tumor / condition

Region of interest

right mandible

Referral reason

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Canaray 176087

Not sure if this was something worth drawing in? Made images below with the second canal and without

1. Large mature focus of sequestering infected cemental dysplasia at site 47

A large mature focus of cemental dysplasia is present at site 47. This entity is comprised of a large amorphous radiopaque mass with a low-density periphery, which extends from the alveolar crest to the level of the inferior alveolar nerve canal. The superior posterior aspect of the entity appears to have been exposed, and exhibits an adjacent zone of rarefying osteitis, which suggests that the entity is secondarily infected. In addition, a dehiscence is visible in the lingual cortical plate adjacent to the anterior aspect of the lesion, and a periosteal bone reaction is present adjacent to the dehisence. These findings together are suggestive of an infected sequestering mature cemental dysplasia, which is the source of the patient's regional pain. The proximity of the lesion to the inferior alveolar nerve may be causing neural symptoms.

2. Early periapical cemental dysplasia associated with tooth 45

A small focus of low density granular bone is present in the periapical area of tooth 45. The buccal and lingual cortical plates remain intact. This reflects an early site of periapical cemental dysplasia. No treatment is required.

The root apex of tooth 45 measures 2.2mm from the right mental nerve.

3. Early periapical cemental dysplasia on tooth 31

A small focus of immature periapical cemental dysplasia is present in the periapical region of tooth 31, and the adjacent lingual cortex is thinned. This is a non-significant incidental finding. No treatment is required. Tooth 31 remains vital.

Florid osseous dysplasia

The presence of multifocal periapical cemental dysplasia in the mandible is consistent with florid osseous dysplasia.

4. Mature cemental dysplasia and dense bone island at site 36

A mature focus of cemental dysplasia is present at the mesial aspect of site 36. This amorphous radiopaque entity is surrounded by a radiolucent periphery and a dense bone island. In the absence of any symptoms, this is a non-significant incidental finding, which has not had any effects on the surrounding structures.

5. Dense bone island at site 46M

A dense bone island is present in the mesial and apical aspects of site 46. This dense bone island will not impede implant placement and demonstrates no effects on the surrounding structures. This is a non-significant incidental finding.

6. Buccal abrasion or abfraction on multiple teeth

Teeth 26, 35, 41, 42, and 45 demonstrate abrasion or abfraction on the buccal surface at the level of the cementoenamel junction.

Incidentally, a small calcification is present in the overlying soft tissues adjacent to the interradicular region of teeth 34 and 35. This represents a non-significant incidental finding.

Periodontal bone loss + calculus

Generalized mild horizontal periodontal bone loss and calculus deposition are evident in the mandibular dentition. Periodontal bone loss of unknown severity is present on the maxillary dentition. Teeth 26, 27, and 28 are over-erupted.

7. Left palatine tonsilloliths

Tonsilloliths are present in the left palatine tonsil. This is an incidental finding with no clinical significance.

8. Multiple subcutaneous calcifications

Subcutaneous calcifications are dispersed throughout the facial region. This is an incidental finding with no clinical significance.