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Case 223355

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Referral category

Disease / syndrome / tumor / condition

Region of interest

42, 43

Referral reason

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Canaray 223355

1. Periapical osseous dysplasia associated with tooth 42

Dense, amorphous globules of bone are present periapical to tooth 42, which appear to be surrounded by a radiolucent rim of variable width. The buccal and lingual cortices are thinned, but remain intact. These findings are suggestive of a focus of periapical osseous dysplasia, which does not require treatment.

2. Periapical osseous dysplasia associated with tooth 43

Dense, amorphous globules of bone are present periapical to tooth 43, which appear to be surrounded by a radiolucent rim of variable width. The root apex of tooth 43 has been displaced distally. The buccal and lingual cortices are thinned, but remain intact. As well, expansion of the buccal cortex is present. These findings are suggestive of a focus of periapical osseous dysplasia. It is unusual for a focus of osseous dysplasia to displace a tooth root. Therefore, radiographic follow-up in nine months time is recommended to substantiate this interpretation.

3. Florid osseous dysplasia

Foci of osseous dysplasia are present periapical to teeth 41, 42, 43, and 46. Periapical periodontal ligament space widening is present on teeth 31,32, 33, and 44. These foci of periodontal ligament space widening may represent early foci of periapical osseous dysplasia. Because multiple foci of periapical osseous dysplasia are present, these findings may represent an overall interpretation of florid osseous dysplasia.

4. Fibrous dysplasia in anterior mandible

An extensive granular bone pattern is present in the anterior mandible. This bone pattern extends from the region inferior to tooth 33 to the region inferior to tooth 43. The definition of the cortical-cancellous boundary in this area has been lost. Localized anatomic expansion of the mandible has occurred. This appearance is suggestive of fibrous dysplasia. The concurrent presence of fibrous dysplasia and multiple foci of periapical cemental dysplasia is unusual. Radiographic follow-up is suggested in one year.

5. Dense bone islands in anterior mandible

Two dense bone islands are present within the alveolar processes in the anterior mandible, apical to teeth 32 and 43.

Axial Views of mandible

These axial cross-sectional images demonstrate a combination of granular and amorphous bone formation around the periapical regions of the mandibular teeth. The overlying cortical plates are thinned and expanded, but remain intact. This reflects the presence of florid osseous dysplasia.

As well, the anterior mandible exhibits a diffuse granular bone pattern and anatomic expansion. These findings may reflect the concurrent presence of fibrous dysplasia.