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Referral details

Case 199027

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Referral category

Impacted / delayed / malpositioned / extra teeth

Region of interest

22-25

Referral reason

[Only visible to logged-in users]

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Canaray 199027

Partially erupted supernumerary tooth (s) at site 22

A supernumerary tooth (s) with conical-shaped morphology is partially erupted at the buccal aspect of site 22. The crown of the supernumerary tooth is positioned mesiobuccal to the cervical level of the crown and coronal third of the root of tooth 22. No resorption has occurred to tooth 22, but the tooth is rotated and displaced. Tooth 23 is congenitally absent. The root of the supernumerary tooth is approximately 75% formed and the root apex is positioned adjacent to the floor of the left maxillary sinus. The residual follicle surrounding the crown appears normal and the periodontal ligament space is visible around the entire root circumference. This suggests the absence of ankylosis. The crown of tooth (s) can be accessed from the buccal aspect of site 22.

Axial views of the supernumerary tooth (s)

These axial cross-sectional images demonstrate the normal appearance of the periodontal ligament space surrounding the root of the supernumerary tooth (s). The residual follicle surrounding the crown of the tooth appears normal. These findings suggest that the tooth is not ankylosed.

Palatally impacted tooth 25

The crown of the slightly distoangularly impacted tooth 25 is positioned at the palatal aspect of the alveolar process, mesiopalatal to the coronal third of the mesiobuccal root of tooth 26 and distopalatal to the coronal third of the root of tooth 24. The crown of the tooth is oriented in mild palatoversion. No resorption is evident on the adjacent permanent teeth, but tooth 24 is rotated and displaced. The limited mesiodistal space between teeth 24 and 26 is a contributing source of impaction of tooth 25. The residual follicle surrounding the crown of tooth 25 appears normal. Root formation is approximately 50% complete and the root apex is positioned at the floor of the left maxillary sinus. No signs of ankylosis are present. The crown of tooth 25 can be surgically accessed from the palatal aspect of the alveolar process, mesial to the coronal half of the palatal root of tooth 26.

Axial views of tooth 25

These axial cross-sectional images demonstrate the normal appearance of the periodontal ligament space surrounding the root of tooth 25. The residual follicle surrounding the crown of the tooth appears normal. These findings suggest that the tooth is not ankylosed.

Normal tooth 21

Tooth 21 appears normal radiographically. There is no evidence of displacement or root resorption in association with its close proximity to the supernumerary tooth(s) at the buccal aspect of site 22. The crown of the supernumerary tooth is positioned distobuccal to the coronal third of the root and cervical level of the crown of tooth 21.

Displaced + rotated tooth 22

The root apex of tooth 22 has been displaced in a distopalatal direction due to its close proximity to the supernumerary tooth (s). There is no evidence of root resorption in tooth 22, but the buccal surface of the crown of the tooth is distally rotated by approximately 60 degrees. The crown of the supernumerary tooth (s) is positioned mesiobuccal to the cervical level of the crown and coronal third of the root of tooth 22.

1. Possible dens invaginatus on tooth 22

An enamel lined cavity may be present at the cingulum region of tooth 22, which is representative of dens invaginatus. No signs of periapical or periradicular pathology are present, despite this finding. Clinical correlation is recommended.

Mild physiologic root resorption of tooth 63

The apical third of the root of tooth 63 exhibits mild physiologic root resorption. Tooth 23 is congenitally absent. The root apex of tooth 63 is positioned distal to the coronal third of the root of the supernumerary tooth (s).

Displaced + rotated tooth 24

The root apex of tooth 24 has been mildly displaced in a mesiobuccal direction and the buccal surface of the crown is rotated distally by approximately 10 degrees. The crown of tooth 25 is positioned distopalatal to the coronal third of the root of tooth 24. The middle third of the root of the supernumerary tooth is positioned mesial to the developing root apex of tooth 24. No resorption has occurred to tooth 24.

Normal tooth 26

Tooth 26 is unaffected by the impacted tooth 25. The crown of tooth 25 is positioned mesiopalatal to the coronal third of the mesiobuccal root and mesial to the coronal half of the palatal root of tooth 26. No resorption is present at tooth 26.

Axial views of the mid second quadrant

These axial cross-sectional images demonstrate the mesiobuccal positioning of the partially erupted supernumerary tooth (s) relative to tooth 22 and the interproximal and the palatal positioning of impacted tooth 25 relative to teeth 24 and 26. Teeth 22 and 24 are rotated and displaced. Tooth 23 is congenitally absent. There is no evidence of root resorption on any of the permanent teeth in this region.

2. Antral pseudocyst + mild mucositis of left maxillary sinus

A small pseudocyst and mild mucositis are present in the left maxillary sinus. These are non-significant incidental findings.