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Referral details

Case 190362

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Referral category

Impacted / delayed / malpositioned / extra teeth

Region of interest

Maxilla

Referral reason

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Canaray 190362

Impacted + partially transposed tooth 23

Teeth 22 and 23 are partially transposed in the dental arch. The crown of the mesioangularly impacted tooth 23 is positioned buccal to the apical half of the root of tooth 22. No root resorption is evident on the adjacent permanent teeth 21, 22, and 24, but teeth 21 and 22 are displaced. Root formation of tooth 23 is complete. The follicle surrounding the crown of the tooth appears normal and communicates with the follicle around tooth 24. No signs of ankylosis are present. The crown of tooth 23 can be surgically accessed from the buccal aspect of the alveolar process, adjacent to the apical half of the root of tooth 22.

Axial views of tooth 23

These axial cross-sectional images demonstrate the normal appearance of the periodontal ligament space lining the root circumference of tooth 23. The follicle surrounding the crown of the tooth appears normal and communicates with the follicle around tooth 24. These findings suggest that tooth 23 is not ankylosed.

Impacted tooth 24

The crown of the mesioangularly impacted tooth 24 is positioned distopalatal to the apical half of the root of tooth 22. No root resorption is evident on the adjacent permanent teeth 21, 22, and 23, but teeth 21 and 22 are displaced. Root formation of tooth 24 appears complete. The follicle surrounding the crown of the tooth is normal and communicates with the follicle around tooth 23. No signs of ankylosis are present. The crown of tooth 24 can be surgically accessed from the palatal aspect of the alveolar process, distal to the apical half of the root of tooth 22.

Axial views of tooth 24

These axial cross-sectional images demonstrate the normal appearance of the periodontal ligament space lining the root circumference of tooth 24. The follicle surrounding the crown of the tooth is normal and communicates with the follicle around tooth 23. These findings suggest that tooth 24 is not ankylosed.

No significant physiologic resorption of tooth 64

Tooth 64 does not exhibit significant signs of physiologic resorption. Tooth 64 may require extraction in order to facilitate the eruption and orthodontic repositioning of tooth 24. Tooth 24 is not in close proximity to tooth 64. The crown of tooth 64 is positioned distal to the coronal half of the root of tooth 63.

Moderate physiologic resorption of tooth 63

Tooth 63 exhibits moderate physiologic root resorption and may require extraction in order to facilitate the eruption and orthodontic repositioning of tooth 23. Tooth 23 is not in close proximity to tooth 63.

Partially transposed + displaced tooth 22

Teeth 22 and 23 are partially transposed in the dental arch. The root apex of tooth 22 is mesially displaced due to the proximity of the impacted tooth 23. The crown of tooth 23 is positioned buccal to the apical half of the root of tooth 22. The crown of tooth 24 is positioned distopalatal to the apical half of the root of tooth 22. No root resorption is noted on tooth 22.

Slightly displaced tooth 21

The root apex of tooth 21 is slightly mesially displaced due to the proximity of the impacted tooth 23. The crown of tooth 23 is positioned distobuccal to the apical half of the root of tooth 21. Tooth 24 is not in close proximity to tooth 21. No root resorption is noted on tooth 21.

Axial views of anterior 2nd quadrant

These axial cross-sectional images demonstrate the impaction of teeth 23 and 24 in the anterior left maxilla. No root resorption is noted on teeth 21, 22, 23, and 24, but teeth 21 and 22 are displaced.

1. Benign tumor at site 23

A well defined unilocular entity with a round shape and the corticated periphery is present at site 23. This entity has displaced tooth 23 mesially, and has caused buccolingual expansion of the alveolar process. Internally, the entity is composed of a heterogeneous mixed pattern, which is suggestive of the presence of many diffuse calcifications. Based on the position of the entity, the age of the patient, and the presence of internal calcifications, the most likely diagnosis is an adeomatoid odontogenic tumor. However, other benign tumors, such as calcifying cystic odontogenic tumors and ossifying fibromas, have a similar appearance.

Orthogonal measurements of lesion in anterior second quadrant

These orthogonal cross-sectional images demonstrate the size of the benign tumor in the anterior second quadrant from various perspectives.