Radiology Forum Each month this section will bring to the reader of ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY information of practical relevance to the art and scienceof diagnostic imaging and diagnostic images with unusual interpretive features. Practical notes and radiographs will be accompanied by an explanation or inquiry. Please submit 5 X 7 inch glossy black-and-white prints of your illustrations. All materials for publication should be submitted to Dr. Allan G. Farman, Department of Primary Patient Care, School of Dentistry, University of Louisville, Louisville, KY 40292.
UNUSUALLY
PLACED
MOLARS
A
37-year-old woman had a history of recurrent episodesof swelling in the left mandibular molar region over a 1%year period. The swellings were not painful but were associated with a bad taste in her mouth. There were no apparent precipitating factors, and the swelling resolved with systemic antibiotics. She had had no paresthesia in this region. The medical history was noncontributory. On clinical examination, her first and secondmandibular left permanent molars were found to be absent; a sinus tract was present over the edentulous ridge in this region. The area was slightly tender but no swelling or pus was seen.The mandibular left second premolar and third molar teeth exhibited a positive response to thermal testing, and there was no mobility or tenderness or percussion. Radiographic examination showed the mandibular left first and second molars to be unerupted (Fig. 1). The second molar was mesioangularly impacted over the first molar and immediately beneath the third molar. The horizontally impacted first molar lay near the lower border of the mandible, and its mesial root was seenin close approximation to the inferior dental canal. Its crown had a mottled radiolucent appearance. A carious lesion was noted in the mesial aspect of the second premolar. The second premolar to the third molar were surgically removed with the patient under endotracheal anesthesia. The postoperative course was uneventful and at review, 1 week later, the area was seen to be healing satisfactorily. The reason for the ectopic position of the first and second permanent molars is ob-
Fig.
1
scure. Mesial tilting after early loss of deciduous molars, ankylosis of the permanent teeth with growth of the supporting alveolus, or displacement of the tooth germs could all be possible contributing factors in this case; but perhaps this is an example of how teeth sometimesappear to move considerably for no apparent reason. Simon N. Rogers, BDS Oral Surgery Department Freeman Hospital Newcastle upon Tyne NE7 7DN, England
STYLOID
PROCESS
HYPERPLASIA
A
62-year-old black man came to the oral surgery unit at the Philadelphia Veterans Administration Medical Center for examination after trauma to the 679
UNUSUALLY
PLACED
MOLARS
A
37-year-old woman had a history of recurrent episodesof swelling in the left mandibular molar region over a 1%year period. The swellings were not painful but were associated with a bad taste in her mouth. There were no apparent precipitating factors, and the swelling resolved with systemic antibiotics. She had had no paresthesia in this region. The medical history was noncontributory. On clinical examination, her first and secondmandibular left permanent molars were found to be absent; a sinus tract was present over the edentulous ridge in this region. The area was slightly tender but no swelling or pus was seen.The mandibular left second premolar and third molar teeth exhibited a positive response to thermal testing, and there was no mobility or tenderness or percussion. Radiographic examination showed the mandibular left first and second molars to be unerupted (Fig. 1). The second molar was mesioangularly impacted over the first molar and immediately beneath the third molar. The horizontally impacted first molar lay near the lower border of the mandible, and its mesial root was seenin close approximation to the inferior dental canal. Its crown had a mottled radiolucent appearance. A carious lesion was noted in the mesial aspect of the second premolar. The second premolar to the third molar were surgically removed with the patient under endotracheal anesthesia. The postoperative course was uneventful and at review, 1 week later, the area was seen to be healing satisfactorily. The reason for the ectopic position of the first and second permanent molars is ob-
Fig.
1
scure. Mesial tilting after early loss of deciduous molars, ankylosis of the permanent teeth with growth of the supporting alveolus, or displacement of the tooth germs could all be possible contributing factors in this case; but perhaps this is an example of how teeth sometimesappear to move considerably for no apparent reason. Simon N. Rogers, BDS Oral Surgery Department Freeman Hospital Newcastle upon Tyne NE7 7DN, England
STYLOID
PROCESS
HYPERPLASIA
A
62-year-old black man came to the oral surgery unit at the Philadelphia Veterans Administration Medical Center for examination after trauma to the 679
