Home Dental Case of the Week – mucosal lining thickening of the left sphenoid sinus

Case of the Week – mucosal lining thickening of the left sphenoid sinus

by adminjay



Alex Woodham explains why it is good practice to assess the entire data set systematically when clinically evaluating a CBCT scan.

Findings

The edentulous regions have mild to moderate vertical bone resorption with moderate density cortical and trabecular bone.

The UL7 edentulous ridge has a well-defined radiopacity measuring 4 x 3 x 6 mm. This extends from the alveolar crest to the sinus floor. It is a dense bony island or retained root tip.

The UR3, UR1 and UL5 are root treated to apices with normal periodontal ligament spaces.

The UR4 is root treated. The buccal root filling is short of the apex with an apical radiolucency 3-4 mm wide. This is probably an apical granuloma or radicular cyst secondary to chronic apical periodontitis. The palatal root canal is filled to the apex with an apical radiolucency 0.5-1 mm wide.

The UL1 has external root resorption, mostly on the palatal side of the root. Approximately a third to half of the root is resorbed. There is no apical radiolucency but the root may be partially ankylosed to the bone. The UL2 also has external root resorption but to a lesser extent.

Both maxillary and left sphenoid sinuses have mild generalised thickening of the mucosal linings. There is no expansion or bony erosion of the sinus walls.

  • Reconstructed panoramic view of the maxilla
  • UR7-4 region cross sections at 2mm intervals. Moderate loss in vertical bone height. The UR4 is root treated. The buccal root filling is short of the apex with 3-4mm wide apical radiolucency. The palatal root canal is filled to the apex with 0.5-1mm wide radiolucency
  • UL3-4 region cross sections at 3mm intervals. Mild loss in vertical bone height. Moderate density cortical and trabeculae bone
  • UL5-7 region cross sections at 3 mm intervals. Moderate loss in vertical bone height. Moderate density cortical and trabeculae bone
  • UL1 showing external root resorption, mostly on the palatal side of the root. Approximately a third to half of the root resorbed. The root may be partially ankylosed to the bone
  • UL7 edentulous ridge. Well defined radiopacity extending from the alveolar bone crest to the sinus floor
  • Axial and coronal slices showing mucosal lining thickening of the left sphenoid sinus

Learning from this case

It is good practice to assess the entire data set systematically when clinically evaluating a CBCT scan.

A thorough approach to examining the volume prompts appropriate management for the patient of any known or incidental findings.


For more information visit dental-scan.co.uk.

Read previous Case of the Week columns

  • Stafne bone cavities
  • Relationship with the inferior dental nerve.



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