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Referral details

Case 196559

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Referral category

Wisdom Teeth

Region of interest

Lt posterior body- Ramus

Referral reason

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Canaray 196559

1. Large benign cystic entity surrounds resorbing dilated odontome at site 38

A well-defined, corticated unilocular cystic entity is present in the left posterior mandible and ramus. The entity extends from the distal surface of tooth 37 to the posterior third of the ramus, and from the base of the coronoid process to the superior cortex of the left inferior alveolar nerve canal. The entity encircles the dilated odontome at site 38. The presence of an enamel-lined cavity with a multilocular appearance within the odontome confirms its presence. There has been hydraulic expansion and thinning of the buccal and lingual cortices of the mandible and the anterior border of the ramus which remains intact. A dehiscence of the lingual cortex is evident opposite the crown of tooth 38. The cystic entity abuts the superior cortex of the inferior alveolar nerve canal and the posterior inferior aspect of the entity directly communicates with the canal's contents. There is no evidence of resorption or displacement of the adjacent tooth 37. This radiologic appearance is suggestive of an odontogenic cystic lesion originating at the dilated odontome, such as a dentigerous cyst. Biopsy and histopathological examination are strongly recommended to confirm the diagnosis.

Axial views of posterior 3rd quadrant

These axial cross-sectional images demonstrate the expansion and thinning of the buccal and lingual cortical plates by the cystic entity in the posterior left mandible. A dehiscence of the lingual cortical plate is evident adjacent to the dilated odontome at site 38. No evidence of resorption is noted on tooth 37.

Mesiodistal views of posterior 3rd quadrant

These mesiodistal cross-sectional images demonstrate the cystic lesion associated with the odontome at site 38. The odontome is connected to the adjacent bone via a septum. Note the cystic entity extends to the superior border of the left inferior alveolar nerve canal and the posterior inferior aspect of the entity directly communicates with the mandibular nerve.

Normally developing tooth 28

Tooth 28 is developing normally in the left maxillary tuberosity. The follicle surrounding the tooth appears normal. No damage has occurred to the distal surface of tooth 27. Root formation has not yet begun.

2. Calcified stylohyoid ligament

The left stylohyoid ligament is partially calcified. This is an incidental finding with no significance.