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Referral details

Case 98107

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Referral category

Troublesome / painful / cracked tooth (Endodontic)

Region of interest

45/46 area

Referral reason

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1 Files Info

Canaray 98107

Normal tooth 46

Tooth 46 appears normal radiographically. The periodontal ligament space is of uniform width around the tooth and the lamina dura is intact. No unobturated canals are radiographically evident. No signs of root fracture are present. The endodontic treatment of the tooth appears to have been successful. This tooth is not the source of the patient's symptoms.

Axial views of tooth 46

These axial cross-sectional images demonstrate the uniform periodontal ligament space and intact lamina dura around the entire root circumference of tooth 46. This radiographic appearance is not suggestive of any pathology originating at tooth 46.

Mesiodistal views of tooth 46

These views as the cross-sectional images demonstrate the normal appearance of the alveolar bone on the mesial and distal surfaces of the roots of tooth 46. Note the absence of any periapical pathology.

Buccolingual views of tooth 46

These buccolingual cross-sectional images demonstrate the intact alveolar bone on the buccal and lingual surfaces of the roots of tooth 46. The mesial and distal root apices are separated from the inferior alveolar nerve canal by 1.4 mm and 2.0 mm, respectively.

Normal tooth 45

Tooth 45 appears normal radiographically. The periodontal ligament space is of uniform width around the tooth and the lamina dura is intact. No unobturated canals are present. No signs of root fracture are present. This tooth does not appear to be the source of patient's symptoms.

Axial views of tooth 45

These axial cross-sectional images demonstrate the normal appearance of the alveolar bone surrounding the root of tooth 45, as well as the absence of any unobturated canals within the root of the tooth.

Mesiodistal views of tooth 45

These mesiodistal cross-sectional images demonstrate the normal appearance of the alveolar bone on the mesial and distal surfaces of the root of tooth 45.

Buccolingual views of tooth 45

These buccolingual cross sectional images demonstrate the intact alveolar bone on the buccal and lingual surfaces of the root of tooth 45. The mental foramen is separated from tooth 45 by normal bone.

Horizontally impacted tooth 48

Tooth 48 is horizontally impacted, and has not had any effect on the surrounding structures. The right inferior alveolar nerve canal passes inferiorly to tooth 48.

1. Possible recurrence of lymphoma in posterior right mandible: medical referral recommended

The inferior alveolar nerve canal appears to be enlarged in the region apical to site 47. The borders of the canal are not clearly visible. Prominent bone marrow spaces are present in the buccal cortical plate in the posterior fourth quadrant. This is an atypical radiographic appearance. The possibility of the presence of an infiltrative lesion (particularly a recurrence of lymphoma) in this region should be investigated as the source of the patient's neural symptoms.

Axial views of posterior fourth quadrant

These axial cross-sectional images demonstrate the enlarged bone marrow spaces that are visible in the buccal cortical plate in the posterior fourth quadrant. Note the poorly-defined borders of the inferior alveolar nerve canal in this region. The possibility of the presence of a recurrent infiltrative tumor originating within the posterior right mandibular body should be ruled out as the source of the patient's symptoms.