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Case 49847

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Referral category

Dental implants

Region of interest

11

Referral reason

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Canaray 49847

1. Radicular cyst on tooth 21MB arising from lateral canal

A well-defined, corticated, cystic radiolucency is centered along the mesiobuccal aspect of the middle third of the root of tooth 21. The overlying buccal cortical plate is thinned and expanded. A lateral canal extends between the root canal system of tooth 21 and the mesiobuccal surface of the root adjacent to this radiolucent entity. This appearance is consistent with a laterally positioned radicular cyst arising from an accessory canal within the midroot level of tooth 21. The apical periodontal ligament space is also slightly widened.

Axial views of tooth 21

These axial cross-sectional images demonstrate the mesiobuccal position of the radicular cyst associated with tooth 21. The remaining periradicular bone appears normal.

Mesiodistal views of tooth 21

These mesiodistal cross-sectional images demonstrate the epicenter of bone loss on the mesiobuccal aspect of tooth 21 adjacent to the foramen of the lateral canal at the midroot level.

Buccolingual views of tooth 21

These buccolingual cross-sectional images demonstrate the hydraulic expansion of the buccal cortical plate adjacent to the mesial aspect of tooth 21. The apical periodontal ligament space is slightly widened.

Normal implant 11

The implant at site 11 appears normal radiographically. No signs of peri-implant bone loss are present around the implant threads. The alveolar bone is intact around the entire circumference of implant 11.

Axial views of implant 11

These axial cross-sectional images demonstrate the normal appearance of the alveolar bone around implant 11.

Mesiodistal views of implant 11

These mesiodistal cross-sectional images demonstrate adequate osseous coverage over the implant threads along the mesial and distal aspects of the implant at site 11. The apical bone also appears normal.

Buccolingual views of implant 11

These buccolingual cross-sectional images demonstrate the intact alveolar bone overlying the buccal and palatal surfaces of the implant cylinder at site 11.

Site 11: Adequate bone

A 4x13mm cylinder was overlaid on the adjacent images at site 11. Adequate bone exists for implant placement at this site.

Site 21: Inadequate mesiobuccal bone density

A 4x13mm cylinder was overlaid on the adjacent images at site 21. Inadequate bone exists for the mesiobuccal aspect of this cylinder to be fully embedded at this site without additional bone augmentation.

Axial views of sites 11 and 21

These axial cross-sectional images demonstrate adequate buccolingual bone volume and mesiodistal space to accommodate the proposed implant cylinder at site 11. Inadequate bone density is present overlying the mesiobuccal aspect of the proposed implant cylinder at site 21.

2. Apex of implant 23 abuts root 24

The apex of the implant at sit 23 abuts the mesial surface of the apical third of the buccal root of tooth 24. No periapical or periradicular pathology is associated with tooth 24, which suggests this may represent an incidental finding.