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Case 91304

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Disease / syndrome / tumor / condition

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Lower right

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Canaray 91304

1. Periapical cemental dysplasia associated with tooth 46M

A well-defined region of granular bone is centered within the periapical region of the mesial root of tooth 46. The overlying buccal cortical plate is thinned and mildly expanded, but remains intact. These radiographic findings are consistent with an area of periapical cemental dysplasia associated with tooth 46. The increased rate of bone turnover associated with periapical cemental dysplasia is the source of the increased technetium uptake noted in the right mandible on the bone scan dated May 11, 2015. No treatment is indicated.

Axial views of tooth 46

These axial cross-sectional images demonstrate the thinned and mildly expanded buccal cortical plate adjacent to the area of periapical cemental dysplasia associated with the mesial root of tooth 46. The mandibular nerve canal remains unaffected.

Mesiodistal views of tooth 46

These mesiodistal cross-sectional images demonstrate granular bone within the periapical region of the mesial root of tooth 46. The distal root apex appears normal.

Buccolingual views of tooth 46

These buccolingual cross-sectional images demonstrate the thinned but intact buccal cortical plate overlying the mesial root apex of tooth 46. Granular bone is present at the mesial root apex. The mesial and distal root apices of tooth 46 are separated from the inferior alveolar nerve canal by 3.2mm and 3.7mm, respectively.

2. Periapical cemental dysplasia associated with tooth 44

A small focus of granular bone is present adjacent to the periapical area of tooth 44, and the contiguous periodontal ligament space is slightly widened. This is most suggestive of another site of periapical cemental dysplasia, and is a non-significant incidental finding.

Axial views of tooth 44

These axial cross-sectional images demonstrate an intact lamina dura and uniform periodontal ligament space around the root of tooth 44. No periradicular pathology is present.

Mesiodistal views of tooth 44

These mesiodistal cross-sectional images demonstrate the intact alveolar bone on the mesial and distal surfaces of the root of tooth 44. The small focus of granular bone at the root apex is most suggestive of a site of periapical cemental dysplasia.

Buccolingual views of tooth 44

These buccolingual cross-sectional images demonstrate the intact alveolar bone on the buccal and lingual surfaces of the root of tooth 44.

3. Periapical cemental dysplasia at site 48

A small radiopaque focus surrounded by granular bone and a corticated periphery is present within the buccal cortex at site 48. This appearance is most suggestive of a small nidus of periapical cemental dysplasia. There are no effects to the surrounding structures, and no treatment is required.