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Referral details

Case 98283

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Referral category

Dental implants

Region of interest

Quad 3-33 D to 36 position, Quad 4- 44D to 46 position

Referral reason

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Canaray 98283

1. Neural tumor in left mandible

There is a well-defined, non-corticated, oval radiolucency located in the left mandible, adjacent to the left mental foramen. At its greatest dimensions, this lesion measures 11.6 mm mesiodistally, 7.4 mm buccolingually, and 10.1 mm superoinferiorly. This entity is continuous with the left inferior alveolar nerve canal, and demonstrates a fusiform shape as it progressively tapers into the canal space. The buccal cortex adjacent to this region appears significantly thinned, but intact. The opening of the left mental foramen demonstrates a relatively normal diameter, which suggests that this entity did not arise from the overlying soft tissues. This entity is not continuous with the apical periodontal ligament spaces of teeth 34 and 35, which suggests that it did not arise secondary to inflammatory disease. These findings suggest the presence of a benign tumor of neural origin in the left mandible, such as a neurofibroma or neurilemmoma. Incisional biopsy and histopathologic correlation is required for a definitive diagnosis.

Axial views of the posterior left mandible

These axial cross-sectional images demonstrate the presence of a well-defined, non-corticated, radiolucent entity in the posterior left mandible which is located immediately adjacent to the left mental foramen. The opening of the left mental foramen appears relatively normal in diameter, which suggests that this lesion did not arise from the soft tissues overlying this region.

Buccolingual views of the posterior left mandible

These buccolingual cross-sectional images demonstrate the thinning of the buccal cortex adjacent to this radiolucent entity. The lingual cortex adjacent to this region appears normal and intact.

Mesiodistal views of the posterior left mandible

These mesiodistal cross-sectional images demonstrate the fusiform appearance of this radiolucent entity as it tapers into the normal diameter of the left inferior alveolar nerve canal. This radiolucent entity does not appear to be continuous with the apical periodontal ligament spaces of the adjacent teeth 34 and 35, which suggests that it did not arise secondary to persistent inflammatory disease.

Generalized periodontal bone loss

There is generalized moderate horizontal bone loss involving the imaged dentition. There is vertical bone loss located along the mesial and distal aspects of tooth 34.

Multiple retained roots

The crowns of the endodontically-treated teeth 13, 12, 22, 23, 35, 34, and 45 appear absent, and the roots of these teeth are retained. There is widening of the periodontal ligament space around the retained root of tooth 34, which suggests the presence of clinical mobility.

2. Extruded endodontic sealer on tooth 23

Extruded sealer is present in the periapical region of tooth 23. This is a non-significant incidental finding with no effects on the adjacent structures.

3. Retained restorative material at site 21

There is a highly radiopaque granule located within the alveolar crest at site 21. This likely represents retained restorative material, and its removal prior to regional implant placement can be considered.

4. Abrasion on tooth 33

Abrasion is present along the buccal surface of tooth 33, at the level of the cemento-enamel junction.

5. Right antral pseudocyst

An antral pseudocyst is present within the right maxillary sinus. This represents an incidental finding with no clinical significance.

6. Palatine tonsilloliths

Tonsilloliths are present in the palatine tonsils. This is an incidental finding with no clinical significance due to the spontaneous exfoliation of tonsilloliths.

7. Moderate cervical degenerative joint disease

Osteophytes and subchondral sclerosis are present in the articulating regions of the Atlas and dens of the cervical vertebrae. This is an incidental finding that is suggestive of moderate cervical degenerative joint disease.

8. Calcified stylohyoid ligaments

The stylohyoid ligaments are partially calcified bilaterally. This is an incidental finding with no clinical significance.