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Referral details

Case 254431

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Referral category

Troublesome / painful / cracked tooth (Endodontic)

Region of interest

assess Radiolucent area 36 - 34

Referral reason

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Canaray 254431

1. Benign aggressive tumor lingual to tooth 35

A unilocular radiolucent entity with a non-corticated periphery is present within the mandibular alveolar process lingual to the coronal two-thirds of the root of tooth 35, extending between teeth 34 and 36. This entity extends lingually and coronally causing significant concentric expansion of the contiguous lingual cortical plate and the lingual aspect of the alveolar crest in this region. The expanded borders appear thin, granular and meet the adjacent normal bone at right angle. The lamina dura along the involved root surface of tooth 35 is lost. There are no signs of teeth displacement or roots resorption. The overall radiological appearance is suggestive of a benign but aggressive tumor arising within the alveolar bone. The differential interpretation includes central giant cell granuloma. This interpretation is substantiated by the young age of the patient. Biopsy and histopathological examinations are recommended to confirm this interpretation.

Orthogonal measurements of lesion in left mandible

These orthogonal cross-sectional images demonstrate the approximate dimensions of the lesion lingual to tooth 35.

Normal tooth 34

Tooth 34 appears normal radiographically. The periodontal ligament space is of uniform width surrounding the root of the tooth and the lamina dura is intact. The radiolucent lesion within the mandibular alveolar process has not affected tooth 34, and there are no signs of periapical or periradicular pathology.

2. Secondarily affected tooth 35Li by the radiolucent lesion

The radiolucent lesion within the mandibular alveolar process abuts the lingual surface of the coronal two-thirds of the root of tooth 35. The lamina dura along the involved root surface of tooth 35 is lost. There are no signs of teeth displacement or roots resorption. No signs of apical pathology or root fracture are present.

Normal tooth 36

The radiolucent lesion within the mandibular alveolar process extends to the mesial surface of the middle third of the mesial root of tooth 36. However, the lamina dura on the mesial root appears intact. Tooth 36 appears normal otherwise.