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Troublesome / painful / cracked tooth (Endodontic)
Region of interest
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Normal periapical and periradicular bone associated with tooth 43
Tooth 43 has not been affected by the rarefying osteitis associated with tooth 44. The periapical and periradicular bone associated with tooth 43 appears normal radiographically. No signs of endodontic or periradicular pathology are present. The periodontal ligament space is of uniform width around the tooth and the lamina dura is intact. No radiographic signs of root fracture are present.
1. Buccal bone loss on tooth 42
The buccal cortical plate is lost on tooth 42 to the level of the coronal third of the root. This bone loss is likely periodontal in origin. The buccal cortex is also thin, but appears to be intact along the middle third of the root. The remaining periradicular bone appears normal
Otherwise normal post-treatment appearance of tooth 41
The endodontically-treated tooth 41 exhibits a normal post-treatment appearance otherwise. The periapical and remaining periradicular bone are intact. No signs of root fracture are evident. The central position of the obturation suggests no unfilled canals are present. The extruded endodontic sealer beyond the root apex, is a non-significant finding.
2. Periradicular bone loss on tooth 41B+L: probable root fracture
Localized periradicular bone loss is observed along the buccal and lingual root surfaces of tooth 41, which extends from the alveolar crest to the mid-root level. The overlying buccal and lingual cortical plates appear partially dehiscent. No signs of root perforation are evident, and a displaced fracture plane cannot be visualized radiographically. The presence of localized periradicular bone loss along opposing surfaces of a tooth root could infer the possibility of a non-displaced fracture plane.
Mild buccal bone loss on the mandibular teeth
Mild bone loss is present on the buccal surfaces of the mandibular anterior teeth. The palatal bone appears normal.
3. Lingual exostoses adjacent to tooth 44
Exostoses composed of cortical bone are present in the right mandible, adjacent to teeth 44. This represents a non-significant incidental finding.