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Case 180336

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Referral category

Wisdom Teeth

Region of interest

28

Referral reason

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Canaray 180336

1. Odontogenic cyst associated with tooth 28

There is a well-defined, corticated, oval radiolucency located pericoronal to the impacted tooth 28. This entity extends from the cemento-enamel junction region of tooth 28 to the periapical regions of teeth 26 and 27. There is no evidence of root resorption in teeth 26 and 27. The floor of the maxillary sinus overlying this region appears significantly elevated in a "hydraulic fashion." The crown of tooth 28 also appears to have been displaced in a distal and palatal direction by this cystic lesion.

These findings suggest the presence of an odontogenic cyst associated with tooth 28, with the most likely interpretation being that of an asymmetric dentigerous cyst. Biopsy with histopathologic correlation is necessary to substantiate this interpretation.

2. Mucous retention cyst adjacent to cystic lesion

A well-defined, non-corticated, dome-shaped radiopacity is evident along the superiorly elevated sinus floor, adjacent to the cystic lesion. The density of this radiopacity is comparable to soft tissue or fluid. These findings suggest the concomitant presence of a small mucous retention cyst, which is an incidental finding.

Orthogonal measurements of the cystic lesion

These orthogonal cross-sectional images demonstrate the approximate mesiodistal, buccolingual, and coronoapical dimensions of the cystic entity in the posterior left maxilla.

Impacted tooth 28

Tooth 28 is horizontally impacted with its crown in palatoversion. The crown of this tooth is located apical to the furcation of tooth 27, but there is no evidence of root resorption. The root apices of this tooth are located between the sinus floor and posterior maxillary wall. The periodontal ligament space surrounding the root circumference of tooth 28 is visualized, which suggests that it is not ankylosed.

Axial views of tooth 28

These axial cross-sectional images demonstrate that the crown of tooth 28 is located within the furcation of tooth 27. There is no evidence of root resorption in tooth 27.

Mesiodistal views of tooth 28

These mesiodistal cross-sectional images demonstrate the horizontal orientation of tooth 28 relative to the long-axis of tooth 27.