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Referral details

Case 182533

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Referral category

Dental implants

Region of interest

Extraction of all remaining teeth in maxilla except the #27 and to place implants in areas 13/16/23/26 areas

Referral reason

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Canaray 182533

Normal remaining edentulous sites in maxilla

The remaining edentulous sites in the maxilla appear normal radiographically. No intraosseous pathology is present.

2. Retained restorative material at site 13

Restorative material is retained in the buccal aspect of the alveolar process at site 13. A small region of low density bone surrounds the retained restorative material.

1. Dense bone island at site 17

A small dense bone island is present within the apical portion of the alveolar process at site 17. This dense bone island has not had any effects on its surrounding structures and is a non-significant incidental finding.

3. History of apical surgery on tooth 11: persistent rarefying osteitis

The root of tooth 11 exhibits a blunted appearance, which suggests a history of apical surgery. A focus of persistent rarefying osteitis is present in the periapical region of the residual root. The overlying buccal cortical plate is partially dehiscent. This appearance is suggestive of persistent endodontic pathology due to the failed apical surgery of tooth 11. The remaining periradicular bone appears normal. There are no signs of a root fracture.

Endodontic sealer has been extruded through the apical foramen of the root and is retained in the rarefying osteitis. This represents a non-significant incidental finding.

4. Periapical rarefying osteitis on tooth 22

The endodontically-treated tooth 22 exhibits periapical rarefying osteitis. The overlying buccal cortical plate is partially dehiscent. The existing obturation is centrally positioned and extends slightly past the radiographic apex. This appearance is suggestive of persistent endodontic pathology due to the failing endodontic treatment of tooth 22. The remaining periradicular bone appears normal. There are no signs of a root fracture.

Absent crown of tooth 23

Tooth 23 appears to have been prepared for a crown. However, no crown is radiographically visible. The endodontically-treated tooth 23 appears normal otherwise.

6. Ectopic bone formation in maxillary sinuses + mild mucositis in right maxillary sinus

Ectopic bone formation is present on the floors of the maxillary sinuses. This is a non-significant incidental finding. Mild mucositis is present within the right maxillary sinus, which also represents a non-significant incidental finding.

5. Hypoplastic maxillary sinuses

The floors of the right and left maxillary sinuses are located slightly superior to the floor of the nasal fossa, suggesting that the sinuses are slightly hypoplastic. This is a non-significant incidental finding.

7. Fibrous dysplasia of skull base

The skull base is partially captured in this image, and exhibits fibrous dysplasia. This could have implications for the potential compression of cranial nerves. Evaluation of the skull base is beyond the scope of oral radiology. Referral to a neurologist would be necessary if any symptoms of cranial nerve compression are present.