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Referral details

Case 185250

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Referral category

Dental implants

Region of interest

possible endodontoc lesions due to hx chin implant. Non responsive 33-43. Please determine position of chin implant screws to position of apices 32-42

Referral reason

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Canaray 185250

1. Possible non-union of bone segments in anterior mandible

A persistent zone of radiolucent separation exists between the mandibular body and the segmented and repositioned bone fragment in the mandibular symphyseal region. At present, the fragment appears to exhibit non-union. The fixation plate is fully seated, and the fixation screws also appear fully seated.

2. Apex of tooth 43 in close proximity to osteotomy plane

The apex of the root of tooth 43 is in close proximity to the osteotomy plane. It is possible that the neurovascular supply to this tooth has been disrupted by the osteotomy. The periapical periodontal ligament space is slightly widened.

3. Fixation screw in contact with apex of tooth 42

A fixation screw is in contact with the mesial aspect of the root apex of tooth 42. The periapical periodontal ligament space of the tooth is slightly widened, which may be a sign of early pulpal pathology. The tooth appears normal otherwise.

Normal tooth 41

Tooth 41 appears normal radiographically. The periodontal ligament space is of uniform width around the root of the tooth and the lamina dura is intact. No signs of endodontic or periradicular pathology are present.

Normal tooth 31

Tooth 31 appears normal radiographically. The periodontal ligament space is of uniform width around the root of the tooth and the lamina dura is intact. No signs of endodontic or periradicular pathology are present.

4. Fixation screw positioned at the apex of tooth 32

A fixation screw is positioned in the apical region of tooth 32, which may have disrupted the neurovascular supply to the tooth. The apical periodontal ligament space of the tooth is slightly widened, which may be suggestive of the presence of early pulp pathology. The tooth appears normal otherwise.

5. Slightly widened PDL space of tooth 33

The apical periodontal ligament space of tooth 33 slightly widened. The osteotomy plane extends into close proximity of the root apex of tooth 33, and may have interrupted the neurovascular supply to the tooth.

Normal tooth 43