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Case 4678

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Mandible

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Canaray 4678

1. Possible periapical cemental dysplasia at site 45

A well-defined mixed radiolucent/radiopaque entity is present at the distal aspect of the apex of the root of tooth 45. Internally, this entity is composed of amorphous calcified material. The periphery of the entity is thickly corticated. The entity has not had any effects on the surrounding structures.

This entity represents a bone dysplasia such as periapical cemental dysplasia. No treatment is recommended, but periodic radiographic follow-up is suggested to ensure that the entity remains static.

2. Periapical cemental dysplasia at tooth 43

A small, well-defined focus of periapical cemental dysplasia is present at the mesial surface of the root apex of tooth 43. This entity has the classic appearance of cemental dysplasia, which is comprised of an amorphous central radiopaque mass, a wide radiolucent periphery, and a sclerotic rim. No treatment is required.

Axial views of mid-fourth quadrant

These axial cross-sectional images demonstrate the amorphous internal pattern of the entity apical to tooth 45, as well as the irregularly shaped periphery that follows the surrounding trabecular pattern, which is supportive of the diagnosis of a bone dysplasia.