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Case 217702

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Referral category

Disease / syndrome / tumor / condition

Region of interest

Right and left jaws

Referral reason

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Canaray 217702

Orthogonal cephalometric views reconstructed from CBCT data

These orthogonal cephalometric views demonstrate the presence of fixation plates and screws in the regions of the right zygomaticofrontal suture, the right and left inferior infraorbital rims, and the right zygoma and anterior wall of the maxillary sinus. A persistent fracture plane is evident within the right zygomaticomaxillary complex, but the remainder of the surgically reduced fracture planes exhibit a normal post-treatment appearance.

1. Fracture of anterolateral and posterolateral right maxillary sinus walls + fracture and displacement of inferior aspect of right zygoma

Displaced and comminuted fracture planes extend through the anterolateral and posterolateral walls of the right maxillary sinus. The inferior aspect of the zygoma is fractured and inferiorly displaced. The residual lateral wall of the right maxillary sinus is medially positioned, and the residual antral air space remains normally aerated. The fixation associated with the inferior orbital rims bilaterally exhibits a normal post-treatment appearance.

Axial views of right maxillary sinus

These axial cross-sectional images demonstrate the fractured and inferiorly displaced inferior aspect of the right zygoma, as well as the fracture planes involving the anterolateral and posterolateral right maxillary sinus walls. The fixation plate extends from the right anterior aspect of the maxillary alveolar process to the zygomatic arch, but is not in contact with bone along the residual anterolateral sinus wall.

2. Healing right condylar neck fracture

A history of fracture involving the right condylar neck is present. The right condyle is inferiorly displaced. A healing bone pattern is present within the fractured region, which suggests that if the patient remains functional and pain-free in this area, no treatment is indicated.

Normal left condyle

The left condyle exhibits a normal radiographic appearance. No history of fracture is noted.

Normal remaining mandible

The remainder of the mandible exhibits a normal appearance. No evidence of a mandibular body fracture is noted. The implant at site 41 also appears normal, but the overlying lingual bone is thin.

Axial views of mandible

These axial cross-sectional images demonstrate the intact buccal and lingual cortices of the mandible. There are no signs of a fracture plane within the mandibular body or alveolar process.

3. Vertical periodontal bone loss on tooth 27DB

The distal aspect of the distobuccal root of tooth 27 demonstrates vertical periodontal bone loss, which extends to the midroot level. Tooth 27 appears normal otherwise.

4. Dense bone island apical to tooth 47

A dense bone island is present in the periapical region of tooth 47. This dense bone island has not had any effects on the surrounding structures, and is a non-significant incidental finding.

5. Enlarged marrow space apical to tooth 37D

A prominent marrow space is present within the mandibular alveolar process apical to the distal root apex of tooth 37. The contiguous lingual cortical plate is thinned, but remains intact.

6. Concha bullosa

The left middle nasal concha contains air. This represents a concha bullosa and is an incidental finding with no clinical significance.

7. Calcified stylohyoid ligaments

The stylohyoid ligaments are partially calcified bilaterally. This is an incidental finding with no clinical significance.