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Case 178195

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Referral category

Disease / syndrome / tumor / condition

Region of interest

Maxilla

Referral reason

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Canaray 178195

1. One potential zone of recurrence of former lesion

When the current scan (greyscale) was overlaid on the prior scan (Canaray case 129435, dated 18 October 2016, shown in red scale), a slight amount of remodelling was noted adjacent to the left maxillary sinus in the region of the maxilla that exhibited the sinus wall defect. This is evidenced by the visible red boundary that is identified of by the arrows in the accompanying images. The only area that is not associated with the sinus that exhibits a bone defect in the current scan is the posterior aspect of the left zygomatic process of the maxilla. This area may be a site of a recurrence and requires continued monitoring.

2. Potential area of concern

One area that demonstrates a slightly cystic scallop margin is identified in the adjacent images with the yellow arrow.

Sagittal views of posterior left maxilla

These sagittal cross sectional images demonstrate the enlargement of the sinus in the region adjacent to the former lesion, which likely represents normal bone remodelling. The prior scan is shown in red scale, and the current scan is shown in greyscale

3. Potential area for continued monitoring

One region that may require continued monitoring is the anterior aspect of the former lesion. This region of bone exhibits a scalloped appearance that is slightly suspicious.

Coronal views of posterior left maxilla

These coronal cross sectional images demonstrate the localized zone of change in the region adjacent to the left maxillary sinus. Overall, the appearance is suggestive of remodelling rather than a recurrence.

4. Axial views of maxilla demonstrating site of concern

These axial cross-sectional images demonstrate the single scalloped defect at the zygomatic process of the maxilla that is a potential site of a recurrence.

5. Rarefying osteitis at tooth 17

Rarefying osteitis is present in the periapical region of the fused roots of tooth 17. The bone surrounding the remaining root surfaces of the tooth appears normal. The overlying maxillary sinus floor appears thinned and may be partially dehiscent. This pattern of bone loss is suggestive of a failing endodontic obturation in the fused root, possibly suggestive of the presence of an unobturated isthmus or distobuccal canal. No signs of fracture are present in tooth 17.

6. Attrition of mandibular anterior teeth

Attrition is present on the incisal surfaces of the mandibular anterior teeth.

7. Mild right maxillary sinus mucositis

Mild mucositis is present on the floor of the right maxillary sinus. This is a non-significant incidental finding.