Radiology forum
Volume 70 Number 2
tween the invagination and the periodontal or periapical tissues. M. John Hicks, DDS, MS, PhD Dental Research Unit and Department of Growth and Development
UNUSUAL
RADIOGRAPHIC
24 1
Catherine M. Flaitz, DDS, MS Department of Growth and Development School of Dentistry University of Colorado Health Sciences Center Denver, CO 80262
ROOT MORPHOLOGY
A
17-year-old black male patient was seen at the oral surgery clinic for diagnosis and treatment of a right-sided facial swelling of 24 hours duration. The
patient had been having odontalgia for 3 days and was afebrile at the time of surgery. Radiographic examination (Fig. 1) revealed a nonrestorable mandibular right first molar with unusual root morphology. Treatment consisted of surgical removal of the mandibular molar. On examination of the tooth, the apical portion was noted to be irregular and shorter than radiographically depicted. Additional surgical exploration did not disclose any retained root fragments. Specimens retrieved from the alveolus were sent for microscopic examination and interpretation. Microscopic evaluation revealed no root anatomy but rather sclerotic cementoid-like material suggestive of chronic focal sclerosing osteomyelitis or condensing osteitis. The facial swelling and odontalgia resolved completely with the patient’s condition being checked at regular intervals. Sinclair
G. Short, DDS Fort Bliss El Paso, TX 79924
Fig.
1.
IDIOPATHIC FOCAL SCLEROSING OSTEOMYELITIS MIMICKING RETAINED TIP
A
ROOT
n asymptomatic 4 X 7 mm radiodense lesion in a healthy 35-year-old white man was noted during the evaluation of full-month radiographs in July 1984. The position, shape, and density of the lesion were
suggestive of a retained root tip and were correlated with the clinical absenceof the mandibular left first premolar. A review of full-mouth radiographs and historical findings from an examination in July 1978 failed to corroborate this impression. At that time, the radiographic appearance of the same area was one of normal trabeculation consistent in pattern and
242
Radiology forum
ORAL SURG ORAL MED ORAL PATHOL August 1990
Fig.
1.
Fig.
2.
density with the adjacent alveolar bone. With the exception of hemisection of the mandibular left first molar in November 1977, no teeth had been extracted since May 1977. (The patient could not recall if and when his mandibular left first premolar had been extracted.) The value of sequential radiographs in differential diagnosis is apparent in this case. Needless surgical
exploration for a suspected root fragment was avoided. John B. Ludlow, DDS, MS Sharon L. Brooks, DDS, MS Department of Oral Diagnosis and Radioiogy The University of Michigan School of Dentistry Ann Arbor, MI 48109
Volume 70 Number 2
tween the invagination and the periodontal or periapical tissues. M. John Hicks, DDS, MS, PhD Dental Research Unit and Department of Growth and Development
UNUSUAL
RADIOGRAPHIC
24 1
Catherine M. Flaitz, DDS, MS Department of Growth and Development School of Dentistry University of Colorado Health Sciences Center Denver, CO 80262
ROOT MORPHOLOGY
A
17-year-old black male patient was seen at the oral surgery clinic for diagnosis and treatment of a right-sided facial swelling of 24 hours duration. The
patient had been having odontalgia for 3 days and was afebrile at the time of surgery. Radiographic examination (Fig. 1) revealed a nonrestorable mandibular right first molar with unusual root morphology. Treatment consisted of surgical removal of the mandibular molar. On examination of the tooth, the apical portion was noted to be irregular and shorter than radiographically depicted. Additional surgical exploration did not disclose any retained root fragments. Specimens retrieved from the alveolus were sent for microscopic examination and interpretation. Microscopic evaluation revealed no root anatomy but rather sclerotic cementoid-like material suggestive of chronic focal sclerosing osteomyelitis or condensing osteitis. The facial swelling and odontalgia resolved completely with the patient’s condition being checked at regular intervals. Sinclair
G. Short, DDS Fort Bliss El Paso, TX 79924
Fig.
1.
IDIOPATHIC FOCAL SCLEROSING OSTEOMYELITIS MIMICKING RETAINED TIP
A
ROOT
n asymptomatic 4 X 7 mm radiodense lesion in a healthy 35-year-old white man was noted during the evaluation of full-month radiographs in July 1984. The position, shape, and density of the lesion were
suggestive of a retained root tip and were correlated with the clinical absenceof the mandibular left first premolar. A review of full-mouth radiographs and historical findings from an examination in July 1978 failed to corroborate this impression. At that time, the radiographic appearance of the same area was one of normal trabeculation consistent in pattern and
242
Radiology forum
ORAL SURG ORAL MED ORAL PATHOL August 1990
Fig.
1.
Fig.
2.
density with the adjacent alveolar bone. With the exception of hemisection of the mandibular left first molar in November 1977, no teeth had been extracted since May 1977. (The patient could not recall if and when his mandibular left first premolar had been extracted.) The value of sequential radiographs in differential diagnosis is apparent in this case. Needless surgical
exploration for a suspected root fragment was avoided. John B. Ludlow, DDS, MS Sharon L. Brooks, DDS, MS Department of Oral Diagnosis and Radioiogy The University of Michigan School of Dentistry Ann Arbor, MI 48109
