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Impacted / delayed / malpositioned / extra teeth
Region of interest
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1. Benign cystic lesion in anterior right mandible
A well-defined unilocular radiolucent cystic lesion is present in the pericoronal region of the vertically impacted tooth 42. This lesion appears to be associated with the follicle of the tooth, but has extended beyond the cementoenamel junction on the buccal surface of the tooth to the midroot level. Small calcifications are visible within the entity in the region buccal to the crown of tooth 42. The lesion has caused buccal expansion of the alveolar process and has displaced tooth 42 lingually. The overall radiographic appearance is suggestive of a benign unilocular odontogenic cystic lesion originating in the pericoronal region of tooth 42, such as an asymmetric dentigerous cyst with dystrophic calcifications or an adenomatoid odontogenic tumor.
Impacted tooth 42
The crown of the vertically impacted tooth 42 is positioned interproximal to the roots of teeth 41 and 43. There is no evidence of root resorption on the adjacent permanent teeth. The roots of teeth 41 and 43 have been displaced. The root of tooth 42 is fully formed and exhibits a prominent apical curve. The periodontal ligament space is not clearly visible on the lingual surface of the root, which suggests the possibility of ankylosis in this region. The retained root of tooth 82 exhibits a fracture and normal physiologic root resorption. Tooth 42 can be surgically accessed from the buccal or palatal aspect of the alveolar process at site 42.
Axial views of tooth 42
These axial cross-sectional images demonstrate that the periodontal ligament space is not fully visualized on the lingual surface of the root of tooth 42, which suggests the possibility of ankylosis in this region. The extent of the cystic lesion relative to tooth 42 is also evident in these images.
Mesially displaced root of tooth 41
The root of tooth 41 has been mesially displaced by the impacted tooth 42. There is no evidence of root resorption on tooth 41. The crown of tooth 42 is positioned distal to the apical half of the root of tooth 41.
Root fracture + normal physiologic resorption of retained root of tooth 82
A vertical root fracture is present in the coronal half of the retained root of tooth 82. A small focus of periapical rarefying osteitis is present on the retained root. The root of tooth 82 exhibits normal physiologic resorption.
Mildly distally displaced root of tooth 43
The root of tooth 43 has been mildly distally displaced by the cystic lesion associated with tooth 42. There is no evidence of root resorption on tooth 43. The crown of tooth 42 is positioned mesial and slightly lingual to the apical two thirds of the root of tooth 43.
Axial views of anterior 4th quadrant
These axial cross-sectional images demonstrate the impaction of tooth 42. The roots of teeth 41 and 43 have been displaced. There is no evidence of root resorption on any of the permanent teeth in this region.