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Case 42912

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Referral category

Impacted / delayed / malpositioned / extra teeth

Region of interest

Q1

Referral reason

[Only visible to logged-in users]

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Canaray 42912

1. Fixation screw impales unerupted tooth 15

A prior fracture of the right zygomatic process of the maxilla has been repaired with metallic fixation plates and screws. One screw passes through the buccal surface of tooth 15 at the midroot level. This is the cause of the eruptive failure of tooth 15.

Impacted tooth 15

Tooth 15 is vertically impacted in the maxilla due to the presence of a fixation screw through the buccal surface of the middle third of the root. The crown of tooth 15 is buccally positioned within the maxilla but oriented in palatoversion, and is positioned mesial to the apical third of the mesiobuccal root of tooth 16. No root resorption has occurred to adjacent tooth 16. The follicle surrounding the crown of tooth 15 appears hyperplastic along the occlusal surface. The root of tooth 15 is fully formed. The crown of tooth 15 can be surgically accessed from the buccal aspect of the alveolar process mesial to the apical third of the mesiobuccal root of tooth 16.

Retained tooth 55

Tooth 55 is over-retained but exhibits extensive physiologic root resorption. The crown of tooth 15 is positioned apical to tooth 55.

Normal tooth 16

Tooth 16 has not been affected by the impacted tooth 15. The crown of tooth 15 is positioned mesial to the apical third of the mesiobuccal root of tooth 16.

Axial views of mid-1st quadrant

These axial cross-sectional images demonstrate extension of a metallic fixation screw through the buccal surface of the root of tooth 15, which has resulted in impaction of tooth 15. These images exhibit the mesial position of tooth 15 relative to the mesiobuccal root of tooth 16. No damage has occurred to tooth 16.

Developing tooth 18 in buccoversion

Tooth 18 is developing in buccoversion in the maxillary alveolar process, which suggests potential future impaction. The crown of tooth 18 is positioned distal and apical to the distobuccal root apex of tooth 17.

Developing tooth 28

Tooth 28 is developing normally in the maxillary alveolar process. The crown of tooth 28 is positioned distal to the middle third of the roots of tooth 27.

Developing teeth 38 and 48

Teeth 38 and 48 are partially captured in this imaging volume, but appear to be developing normally at this time.

2. Dense bone island within odontoid process

The tip of the odontoid process exhibits a sclerotic internal bone density. There are no radiographic findings suggestive of cervical degenerative joint disease. This suggests the area of high bone density may represent a dense bone island, which is an incidental finding with no clinical significance.