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Referral details

Case 99900

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Referral category

Facial or muscle pain / paralysis / unusual sensations

Region of interest

Mandibular left IAN

Referral reason

[Only visible to logged-in users]

0 Files Info

Canaray 99900

1. History of perforation of inferior alveolar nerve canal with dental bur

A small cylindrical defect that is approximately 1.5 mm in diameter extends from the extraction socket at site 38 and to the lingual aspect of the inferior alveolar nerve canal. This radiographic appearance is suggestive of a history of perforation of the nerve canal with a dental bur. Low-density granular bone is forming at the periphery of the extraction socket and within this bur defect. This is indicative of a healing bone pattern.

Orange nerve overlay added to previous image

An orange overlay of the inferior alveolar nerve canal has been added to the previous report image. The extension of the bur hole into the lingual aspect of the canal is evident in these images.

Axial views of site 38

These axial cross-sectional images demonstrate the extension of the bur hole into the lingual aspect of the posterior left mandibular body. The bur hole has produced localized thinning of the lingual cortical plate, and has effaced the cortical boundary of the lingual aspect of the canal.

Orange nerve overlay on previous image

An orange nerve overlay has been superimposed over the previous report image.

Buccolingual views of site 38

These buccolingual cross-sectional images demonstrate the loss of the lingual superior cortical boundary of the inferior alveolar nerve canal in the region adjacent to site 38.

Orange nerve overlaid on previous image

An orange nerve is overlaid on the previous report image.

Mesiodistal views of posterior third quadrant

These mesiodistal cross-sectional images demonstrate the bur hole that extends from the extraction socket of tooth 38 to the superior lingual aspect of the inferior alveolar nerve canal.

Orange nerve overlaid on previous image

An orange nerve was superimposed over the previous report image.

Right mandibular nerve lingual to 48MB+D, inferior to 48ML

The right inferior alveolar nerve canal passes lingually to what appear to be the mesiobuccal and distal root apices of tooth 48. The nerve passes inferiorly to the mesiolingual root of the tooth. However, the resolution of this cone beam CT scan is low, and it is not possible to definitively determine whether small dense bone islands are present in the periapical regions of the roots of the tooth, or whether the roots are elongated. An intraoral radiograph of tooth 48 is recommended.

Buccolingual views of tooth 48

These buccolingual cross-sectional images demonstrate the lingual passage of the left inferior alveolar nerve canal relative to the mesiobuccal and distal root apices of tooth 48. The inferior passage of the nerve relative to the mesiolingual root of the tooth is also evident in these images.

2. Healing extraction sockets at sites 18 and 28

The extraction sockets at site 18 and 28 are healing normally. Low-density granular bone is forming at the peripheries of the healing sockets.