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Impacted / delayed / malpositioned / extra teeth
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Volume rendering of tooth 23
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1. Odontogenic cyst or tumor associated with impacted tooth 23
A well-defined, partially corticated, unilocular radiolucency is associated with the follicle of the impacted tooth 23. Tooth 23 has been displaced posteriorly into the left posterior maxilla, and the crown of tooth 23 is located apical to the edentulous 27 site. The root of tooth 22 is mesially displaced, and the apical half of the roots of tooth 24 are distally dilacerated. The sinus floor is displaced superiorly to the level of the orbital roof, which has resulted in complete opacification of the antral cavity by this pericoronal radiolucency. Expansion of the buccal cortical plate is evident, and the lesion extends through the medial antral wall into the left inferior and middle meatus.
These findings suggest the presence of a benign odontogenic cyst or tumor associated with the impacted tooth 23. A dentigerous cyst is the most likely interpretation. Biopsy and histopathologic confirmation is required.
Orthogonal views of tooth 23
These orthogonal cross-sectional images demonstrate the relative position of the displaced and impacted tooth 23 within the left posterior maxilla. Note the prominent mesial dilaceration of the apical third of the root of tooth 23.
Orthogonal measurements of cystic lesion in left maxilla
These orthogonal cross-sectional images demonstrate the approximate dimensions of the cystic lesion in the left maxilla.
Axial views of maxilla
These axial cross-sectional images demonstrate extension of the pericoronal radiolucency associated with the impacted tooth 23 from the maxillary midline to the left tuberosity and from the expanded buccal cortical plate to the nasal septum.
Coronal views of maxilla
These coronal cross-sectional images demonstrate effacement of the medial wall of the left maxillary sinus secondary to the pericoronal radiolucency associated with the impacted tooth 23. Lesional extension into the left inferior and middle meati is noted.
Sagittal views of left posterior maxilla
These sagittal cross-sectional images demonstrate a double cortex at the superior aspect of the left maxillary sinus, which reflects elevation of the sinus floor to the level of the orbital floor due to the pericoronal radiolucency associated with the impacted tooth 23. This confirms the origin of this lesion is within the alveolar process as opposed to within the antral cavity itself.
2. Buccal abrasion on teeth 12 and 13
The buccal surfaces of teeth 12 and 13 exhibit abrasion at the level of the cementoenamel junction.
3. Intracranial calcification of right internal carotid artery
Focal calcifications are visible lining the walls of the cavernous portion of the right internal carotid artery. These findings may represent signs of cerebral atherosclerosis, which could potentially increase the risk of future cerebrovascular events. The significance of this finding cannot be determined based on CBCT imaging alone.
4. Mild cervical degenerative joint disease
Small osteophytes and mild subchondral sclerosis are present in the articular regions of the atlas and dens of the cervical vertebrae. This is a common incidental finding with no clinical significance that is suggestive of mild cervical degenerative joint disease.
5. Elongated styloid processes
The styloid processes are elongated bilaterally. This is an incidental finding with no significance.