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Case 235962

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Referral category

Dental implants

Region of interest

#13-23 and Pan

Referral reason

[Only visible to logged-in users]

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Canaray 235962

1. Osseous defect at site 12

A corticated defect is present within the alveolar process at the edentulous site 12. This defect extends through the buccal and palatal cortical plates. This likely reflects an area of prior endodontic pathology, which has incompletely healed and has filled with soft tissue. This defect reduces the bone volume available for regional implant placement.

The socket preservation at site 12 has healed normally and exhibits a density that is similar to that of the adjacent trabecular bone.

2. Partially healed socket preservation at site 22

A history of socket preservation is present in the anterior maxilla at sites 11, 12, 21, and 22. A region of low bone density is present in the apical portion of the extraction socket at site 22 which suggests that the socket preservation material did not fully osseointegrate in this region. The remainder of the socket preservation material in the anterior maxilla has healed normally and exhibits a density that is similar to that of the adjacent trabecular bone.

3. Periapical rarefying osteitis on tooth 13

Rarefying osteitis is present in the periapical region of the endodontically-treated tooth 13. This bone loss extends along the mesiopalatal surface of the apical third of the root and appears to be draining through the osseous defect at site 12. An endodontic post is present in the root, which extends to the coronal half of the root. The remainder of the root remains unobturated. This appearance is suggestive of persistent endodontic pathology. The remaining periradicular bone appears normal. There are no signs of a root fracture.

4. Mild crestal bone loss on implant 16P

The implant at site 16 is partially captured in this imaging volume. Mild crestal bone loss appears to be present along the palatal aspect of tooth 16 and its coronal most-thread may be exposed. The apex of the implant extends through the floor of the right maxillary sinus. No significant antral inflammation is present, which suggests this is a non-significant incidental finding. The mesial surface of the implant is poorly visualized due to the presence of beam hardening artifacts. A periapical radiograph is recommended in order to evaluate this region of the implant. The remainder of the implant captured in this field of view appears normally osseointegrated.

5. Apex of implant 15 extends through sinus floor

The apex of the implant placed at site 15 extends slightly beyond the floor of the maxillary sinus. No significant antral inflammation is present, which suggests this is a non-significant incidental finding. The mesial and distal surfaces of the implant are poorly visualized due to the presence of beam hardening artifacts. A periapical radiograph is recommended in order to evaluate these regions of the implant. The remainder of the implant appears normally osseointegrated.

6. Periradicular bone loss on tooth 26P

Tooth 26 is partially captured in this imaging volume. Periradicular bone loss surrounds the palatal root of the endodontically-treated tooth 26, which extends from the alveolar crest to the apical third of the root. This bone loss extends into the furcation of the tooth. The periodontal ligament space on the remaining root surfaces of the palatal root is widened, which suggests the presence of clinical mobility. This pattern of bone loss could have arisen from localized periodontal disease or a non-displaced root fracture on the palatal root of tooth 26. No further comments can be made based on this limited field of view. Further radiographic investigation of this tooth is recommended.

7. Widened PDL space on tooth 25

There is focal widening of the periodontal ligament space along the distal surface of the middle third of the root of tooth 25. This may represent an early sign of endodontic pathology, possibly related to a lateral canal in this region of the root. The periapical periodontal ligament space on tooth 25 is also widened, suggesting an early stage of tooth devitalization. Clinical vitality testing is recommended to confirm this interpretation. The remaining periradicular bone appears normal. There are no signs of a root fracture.

8. Widened PDL space on tooth 24

Tooth 24 is a morphologic variant whereby its buccal and palatal roots are fused by an isthmus region. The periapical periodontal ligament space on the roots of tooth 24 is widened. The existing obturations in the tooth extend to their radiographic apices. This may represent persistent low-grade endodontic pathology or a healing post-treatment appearance. The remaining periradicular bone appears normal. There are no signs of a root fracture.