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Case 81622

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Canaray 81622

History of Le Fort procedure

The maxilla exhibits a history of a Le Fort Type 1 procedure. The metallic fixation plates and screws present in this imaging volume demonstrate a normal post-surgical appearance. No significant radiographic findings are evident.

Pre-operative orthogonal views of maxilla

These orthogonal cross-sectional images from October 2, 2014, demonstrate the pre-operative appearance of the maxilla. No asymmetries are evident.

Post-operative axial views of maxilla

These axial cross-sectional images demonstrate a normal post-surgical appearance of the maxilla. The antral air spaces are clear bilaterally.

Pre-operative axial views of maxilla

These axial cross-sectional images demonstrate the pre-operative appearance of the maxilla.

History of sagittal split osteotomy

The metallic fixation screws in the right and left posterior mandible are consistent with a history of a bilateral sagittal split osteotomy. The fixation screws extend slightly through the lingual cortical plates.

Pre-operative orthogonal views of mandible

These orthogonal cross-sectional images from October 2, 2014, demonstrate the pre-operative appearance of the mandible. No asymmetries are evident.

Post-operative axial views of mandible

These axial cross-sectional images demonstrate a normal post-surgical appearance in the mandible following a sagittal split osteotomy procedure.

Pre-operative axial views of mandible

These axial cross-sectional images demonstrate the pre-operative appearance of the mandible.

Post-operative coronal views of maxilla and mandible

These coronal cross-sectional images demonstrate a normal post-treatment appearance of the maxilla and mandible following orthognathic surgery. No signs of pathology are radiographically evident.

Pre-operative coronal views of maxilla and mandible

These axial cross-sectional images demonstrate the pre-operative appearance of the maxilla and mandible.

1. Rarefying osteitis on tooth 36M+D

The mesial and distal root apices of the endodontically treated tooth 36 exhibit small foci of periapical rarefying osteitis. No unfilled canals are radiographically evident and there are no signs of root fracture. Clinical evaluation of tooth 36 is indicated to rule out the possibility of persistent periapical pathology.

2. Possible rarefying osteitis on tooth 17MB

An osseous defect is present within the maxillary alveolar process along the mesial aspect of the apical half of the mesiobuccal root of tooth 17. This may reflect endodontic pathology arising from a lateral canal. Vitality testing and clinical evaluation of tooth 17 is indicated.

3. Widened PDL space on tooth 46M

The periapical periodontal ligament space of the mesial root of tooth 46 is slightly widened. This most likely represents a healing post-treatment appearance.

4. Calcified cornua of thyroid cartilage

Both cornua of the thyroid cartilage are partially calcified. This is an incidental finding with no significance.

5. Dense bone island in left greater wing of sphenoid bone

A dense bone island is present in the left greater wing of the sphenoid bone. This is a non-significant incidental finding.

6. Left palatine tonsillolith

A tonsillolith is present in the left palatine tonsil. This is an incidental finding with no clinical significance because tonsilloliths exfoliate spontaneously.

7. Mild cervical degenerative joint disease

Small osteophytes 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.

8. Persistent spheno-occipital synchondrosis

The left lateral aspect of the spheno-occipital synchondrosis in the clivus is preserved. The right lateral aspect is no longer visible. This represents a normal anatomic variant.