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Case 189266

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Disease / syndrome / tumor / condition

Region of interest

Mandible

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Canaray 189266

1. Simple bone cyst and periapical cemental dysplasia in posterior 3rd quadrant

A combination of sclerotic radiopaque foci and granular bone are present within the alveolar process in the posterior third quadrant. These heterogeneous regions of bone formation are surrounded by sclerotic peripheries. The buccal and lingual cortical plates are focally thinned and mildly expanded, but remain intact. These radiographic findings are consistent with multiple foci of cemental dysplasia at various stages of maturity, also referred to as florid osseous dysplasia. A concomitant simple bone cyst is present in the periapical region of tooth 37.

2. Simple bone cyst + periapical cemental dysplasia at tooth 37

An immature focus of cemental dysplasia is present in the periapical region tooth 37. A focus of sclerotic bone is present apical to the mesial root of tooth 37, and low-density granular bone is visible surrounding this entity. A simple bone cyst is associated with this lesion and extends around the root apices of tooth 37. The buccal and lingual cortices are thinned and slightly expanded, but remain intact. This entity has extended around the superior aspect of the inferior alveolar nerve canal, without affecting the passage of the canal.

3. Dense bone island or mature cemental dysplasia at 36D

A dense bone island or mature focus of periapical cemental dysplasia is present surrounding the distal root of tooth 36. The distal root of tooth 36 appears continuous with this entity and the periodontal ligament space of the root is not visible in the apical third of the root. This entity abuts the superior surface of the left inferior alveolar nerve canal.

4. Periapical cemental dysplasia associated with tooth 36

Well-defined regions of amorphous, sclerotic bone are present in the periapical region of the roots of tooth 36. Granular bone formation surrounds these sclerotic foci. The contiguous buccal and lingual cortical plates are thinned and mildly expanded, but remain intact. These radiographic findings are consistent with mature periapical cemental dysplasia. No treatment is required.

5. Partially mature periapical cemental dysplasia at tooth 35

A partially mature focus of cemental dysplasia is present in the periapical region of tooth 35. This amorphous semi-radiopaque entity is surrounded by low-density granular bone and a sclerotic periphery. The periodontal ligament space surrounding tooth 35 does not appear to have been affected, and no treatment is required.

6. Mature cemental dysplasia apical to tooth 46

A mature focus of cemental dysplasia is present in the apical region of tooth 46, extending from the distal aspect of site 46 to the apical region of tooth 45. This entity is comprised of an amorphous radiopaque central region that is surrounded by a radiolucent rim and a sclerotic periphery. The buccal and lingual cortical plates are focally thinned and mildly expanded, but remain intact. The inferior alveolar nerve canal passes along the inferior aspect of the lesion. No signs of unfilled canals or root fractures are present on tooth 46.

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7. Mature cemental dysplasia apical to tooth 45

The mature focus of cemental dysplasia in the fourth quadrant extends into the periapical region of tooth 45. The periodontal ligament space surrounding tooth 45 appears normal radiographically, and tooth 45 likely does not require any treatment. Vitality testing can be performed to confirm this interpretation.

8. Immature periapical cemental dysplasia at tooth 25

A small focus of low density granular bone is present in the periapical region of tooth 25. This represents immature periapical cemental dysplasia, which is an incidental finding with no clinical significance. The remaining bone surrounding tooth 25 appears normal radiographically, and no signs of unfilled canals or root fractures are present.

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9. Right palatine tonsillolith

A tonsillolith is present in the right palatine tonsil. This is an incidental finding with no significance because tonsilloliths exfoliate spontaneously.

10. Subcutaneous calcifications in facial skin

Multiple subcutaneous calcifications are present in the facial skin. This is an incidental finding with no clinical significance.

11. Calcified stylohyoid ligaments

The stylohyoid ligaments are partially calcified bilaterally. This is an incidental finding with no clinical significance.