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Troublesome / painful / cracked tooth (Endodontic)
Region of interest
Left Mandible and Maxilla
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1. Large unilocular cystic lesion in left maxillary tuberosity
A large unilocular radiolucent cystic lesion with a thin corticated periphery is present in the left x-ray tuberosity. This lesion has displaced the sinus floor superiorly, and has also caused marked expansion of the buccal cortical plate. The lesion extends into the distal furcal region of tooth 27. The roots of tooth 27 have not been affected. The overall radiographic appearance is suggestive of a benign unilocular odontogenic cyst or cystic tumors, such as an odontogenic keratocyst.
Secondarly affected tooth 27
The unilocular cystic lesion originating in the left maxillary tuberosity extends into the distal furcal region of tooth 27. Tooth 27 does not exhibit any periapical pathology. The overall radiographic appearance suggests that this tooth has been secondarily affected.
Screen for nevoid basal cell carcinoma syndrome
The presence of multiple odontogenic keratocysts may be a sign of the presence of nevoid basal cell carcinoma syndrome. Screening for this syndrome is indicated.
2. Odontogenic keratocyst at site 38
A radiolucent entity with a corticated periphery is present at site 38. This entity has an undulating shape, and extends anteriorly into the periapical region of tooth 37 and posteriorly into the left mandibular ramus. The inferior alveolar nerve canal has been locally displaced in a buccal and inferior direction by the lesion. Mild lingual expansion of the alveolar process has occurred. The lesion has marsupialized through the alveolar crest at site 38. The overall radiographic appearance is suggestive of an odontogenic keratocyst in the posterior left mandible.
Secondarly affected tooth 37
The lesion originating at site 38 extends around the distal and inferior aspects of the roots of tooth 37. The tooth does not exhibit any resorption or damage, and has been secondarily affected by the lesion. Tooth 37 likely remains vital