Clinical Information:
LR7 RCT done 15 years ago. Patient has had two episodes of swelling, one of which required and incision and drainage. Assess LR7 for any pathology.
Scanning Protocol:
CS 8200 3D
5x5cm FOV, 0.75voxels, 90kVp, 6mA, 15 seconds
Radiation Dose:
Approximately 0.01 mSv
Xelis Dental Viewer (Windows)
Allows you to plan your patient’s treatment easily, with a full implant library and free virtual implant placement capabilities. Our clinical team will prepare a study that includes: a panoramic curve, custom reconstructed 3D, highlighting the inferior dental canal, and image rotation according to the area of interest.
Romexis (MacOS/Windows)
Planmeca Romexis®️ is our flexible and intuitive all-in-one dentistry software platform. Allows you to plan your patient’s treatment easily, with a full implant library and free virtual implant placement capabilities. Our clinical team will prepare a study that includes: a panoramic curve, custom reconstructed 3D, highlighting the inferior dental canal, and image rotation according to the area of interest.
Findings:
- The LR7 has one root and three canals. The buccal canals are merging at the level of the apical third and continuing as one canal with one apex. The distal canal is in a buccal position. The endodontic treatment is reaching the apices with presence of a 9 mm diameter periapical lesion (Image 2).
- The lesion is causing interruption of the lingual cortex and thinning and possible interruption of the mandibular canal. A periosteal reaction is noted on the lingual aspect of the alveolar crest (Image 3).
- Differential diagnosis in this case is periapical periodontitis of the LR7 with osteomyelitis. Prognosis of the tooth is poor, enucleation and biopsy are needed; however, attention should be made to avoid interrupting the content of the mandibular canal that is situated in close contact with the lesion.
Image 1.
Panoramic reconstruction
Image 2.
The LR7 has one root and three canals. The buccal canals are merging at the level of the apical third and continuing as one canal with one apex. The distal canal is in a buccal position. The endodontic treatment is reaching the apices with presence of a 9 mm diameter periapical lesion
Image 3.
The lesion is causing interruption of the lingual cortex and thinning and possible interruption of the mandibular canal. A periosteal reaction is noted on the lingual aspect of the alveolar crest
3D Reconstruction (Invivo)
Thank you for your continued referrals.
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