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Case 77402

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Referral category

Impacted / delayed / malpositioned / extra teeth

Region of interest

75

Referral reason

[Only visible to logged-in users]

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Canaray 77402

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Developing tooth 35 causing impaction of tooth 75

The partially calcified crown of tooth 35 is located immediately coronal to the vertically impacted tooth 75, and is the likely cause of its impaction. This is a rarely reported phenomenon whereby the permanent tooth germ is causing impaction of a deciduous tooth. The crown of tooth 35 is located immediately mesial to the coronal half of the mesial root of tooth 36, but there is no evidence of root resorption. Root development in tooth 35 has not yet begun. The follicle surrounding this tooth appears normal. The crown of tooth 35 can be surgically accessed from the buccal or lingual aspect of the alveolar process, just mesial to the coronal half of the mesial root of tooth 36.

Normal tooth 36

Tooth 36 appears normal radiographically. There is no evidence of displacement or root resorption in association with its close proximity to the impacted tooth 35. The developing crown of tooth 35 is located immediately mesial to the coronal half of the mesial root of tooth 36. The crown of tooth 75 is located immediately mesial to the apical half of the mesial root of tooth 36.

Impacted and partially resorbed tooth 75

The deciduous tooth 75 is vertically impacted due to its paradoxical relationship with the developing tooth 35. The crown of tooth 75 is located immediately apical and slightly buccal to the developing crown of tooth 35. Root development in tooth 75 appears complete, and its root apices are located immediately superior to the inferior mandibular cortex. Ill-defined external resorption is evident in the mesial and distal roots of this tooth, and normally appearing alveolar bone has filled into these resorptive defects, which is consistent with inostosis. The left inferior alveolar nerve canal passes immediately lingual to the mesial and distal roots of tooth 75, and appears moderately compressed in these regions. The follicle surrounding the crown of tooth 75 appears normal. The crown of this impacted tooth can be surgically accessed from the buccal aspect of the alveolar process, just mesial to the apical half of the mesial root of tooth 36.

Axial views of teeth 35, 75

These axial cross-sectional images demonstrate that the partially calcified crown of tooth 35 is located immediately coronal to the vertically impacted tooth 75. Note the presence of ill-defined external resorption involving the roots of tooth 75, which appear to have partially filled in with bone. There is no evidence of root resorption in the adjacent tooth 36.

1. Left palatine tonsilloliths

Tonsilloliths are present in the left palatine tonsil. This is an incidental finding with no clinical significance.