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Case 25014

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Referral category

Wisdom Teeth

Region of interest

48

Referral reason

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Canaray 25014

Right mandibular nerve buccal to tooth 48

The right mandibular nerve courses buccally to the crown and cervical third of the root of tooth 48. The nerve is mildly compressed by tooth 48.

1. Dentigerous cyst on tooth 48

A large cyst is present around the crown of tooth 48, and has displaced the tooth inferiorly. No root resorption has occurred on the distal surface of tooth 47. The cyst has marsupialized through the crest of the alveolar process distal to tooth 47. No buccolingual expansion has occurred.

2. Orthogonal views of dentigerous cyst at tooth 48

These orthogonal cross-sectional images demonstrate the marsupialized dentigerous cyst around the crown of tooth 48, which exhibits minimal buccolingual expansion. Calcification is present on the crown of tooth 48, and hypercementosis is present around the roots of the tooth, which may increase the difficulty of the extraction of this tooth. The bone surrounding the cyst appears sclerotic.

Sagittal views of tooth 48

These sagittal cross-sectional images demonstrate the hypercementosis around the root of tooth 48, and the irregularly shaped unilocular cystic entity around the crown of tooth 48.

Coronal views of tooth 48

These coronal cross-sectional images demonstrate the lingual position of the crown of tooth 48 in the mandibular alveolar process, as well as the presence of a tonsillolith in the right palatine tonsil.

Axial views of tooth 48

These axial cross-sectional images demonstrate the buccal course of the mandibular nerve relative to tooth 48, as well as the posterior inferior position of the crown of tooth 48 relative to the distal surface of tooth 47.

3. Palatine tonsillolith

A tonsillolith is present in the right palatine tonsil. This is an incidental finding with no clinical significance because tonsilloliths exfoliate spontaneously.

4. Widened PDL space on tooth 47D

The distal root of tooth 47 exhibits a widened periapical periodontal ligament space. The vitality of tooth 47 should be investigated.