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Case 237617

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Referral category

Disease / syndrome / tumor / condition

Region of interest

maxillary cyst

Referral reason

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Canaray 237617

1. Odontogenic cyst or benign tumor in anterior left maxilla

There is a well-defined, corticated, oval radiolucency located within the anterior left maxilla, which was partially captured in this imaging volume. This entity extends mesially to the region of the edentulous site 11, distally to the mesial aspect of site 26, and superiorly to involve the contiguous nasal and sinus floors. This entity crosses the anatomic midline, obliterating the nasopalatine canal space, and has encroached the right palatal shelf. The complete anterolateral extent of this lesion is not fully captured.

Extensive, "hydraulic" expansion is observed along the contiguous buccal and palatal surfaces of the alveolar process, the nasal and sinus floors, as well as along the left hard palate. The cortical bone overlying these regions appear significantly thinned and may be partially dehiscent. Tooth 23 may have been displaced in a buccal direction, while tooth 25 appears to have been displaced in a distobuccal direction. Mild external resorption is observed along the mesial root surface of tooth 25.

These findings suggest the presence of an odontogenic cyst or benign tumor. The differential interpretation can include a residual cyst, keratocyst, or unicystic ameloblastoma. Given its extremely expansile appearance, a central giant cell lesion is also possible. Histopathologic correlation is recommended to reach a definitive diagnosis.

2. Mild external resorption on tooth 25M

Due to its close proximity to the cystic lesion, mild external resorption is observed along the mesial surface of the apical third of the root of tooth 25.

3. Retained root fragment at site 14

There is an ovoid shaped radiopacity located within the edentulous site 14, which exhibits a density comparable to dentin. A faint periodontal ligament space is evident around this radiopacity. These findings suggest the presence of a retained root fragment. There is no radiographic evidence of inflammatory disease in the adjacent alveolar bone.

4. Small dense bone island or retained root tip at site 26

A small, irregularly shaped radiopacity is evident within the alveolar process at site 26. The density of this radiopacity is comparable to dentin or cortical bone. These findings could suggest the presence of a small dense bone island or a retained root tip.

5. Dense bone island at site 46D

A dense bone island is present in the alveolar bone at the distal aspect of the edentulous site 46. This dense bone island demonstrates no effects on its surrounding structures. This is a non-significant incidental finding.