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Impacted / delayed / malpositioned / extra teeth
Region of interest
# 11-13 apical region
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1. Benign odontogenic cyst or cystic tumor associated with impacted supernumerary tooth in right anterior maxilla
A vertically impacted and inverted supernumerary tooth is present in the right anterior maxilla palatal to the root of tooth 12. A large unilocular radiolucency is associated with the pericoronal region of the impacted supernumerary tooth, which has caused thinning of the overlying cortical plates and dehiscence of the buccal cortex interproximal to teeth 12 and 13, as well as mild palatal expansion. No resorption is noted on the adjacent teeth, but the root of tooth 13 is distally tipped. Intracoronal resorption is noted within the supernumerary tooth, which is a non-significant incidental finding.
This radiographic appearance is consistent with a benign odontogenic cyst or cystic tumor associated with the impacted supernumerary tooth. This may reflect a dentigerous cyst or an odontogenic keratocyst. However, a biopsy and histopathologic assessment are indicated for a definitive diagnosis.
Teeth 11 and 12 unaffected by impacted supernumerary tooth
Teeth 11 and 12 are not affected by the impacted supernumerary tooth or the associated pericoronal radiolucency. The crown of the supernumerary tooth is positioned palatal to the root apex of tooth 12.
Displaced tooth 13
The root apex of tooth 13 is distally displaced due to the proximity of the pericoronal radiolucency associated with the impacted supernumerary tooth (s). There is no evidence of root resorption on tooth 13.
Axial views of anterior 1st quadrant
These axial cross-sectional images demonstrate the area of buccal cortical dehiscence interproximal to the roots of teeth 12 and 13, as well as mild expansion of the palatal cortical plate adjacent to the pericoronal radiolucency associated with the impacted supernumerary tooth (s). Note the absence of resorption on the adjacent teeth. The root of tooth 13 is distally displaced.