Case of the Week - Periapical Lesion of Pulpal Origin

Imaging Location:
Dental Scan Manchester
Suite 1, Trafalgar House
110 Manchester Rd, Altrincham, WA14 1NU

Scanner Used:
DEXIS OP 3D LX
(RRP £72,000 contact us for more info)

Clinical Information:
Assessment of UR2. Persistent lesion after re-RCT surgery

Scanning Protocol:
5x5cm FOV, 0.12 voxels, 95kVp, 9mA,
Exposure duration: 11.5 seconds

Radiation Dose:
Approximately 0.12 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 UR2 is endodontically treated and shows a large, well-defined, round, periapical radiolucency of approximately 10mm in diameter (Image 2).
The lesion has perforated both the buccal and palatal cortical plates.
The lesion envelops the apical third of the UR2 root and abuts the roots of the UR3 and UR1 in the apical third (Image 3).
The radiographic findings are consistent with a periapical lesion of pulpal origin (suspected an infected radicular cyst).
Surgical treatment of the lesion is indicated. Apex resection or extraction of the UR2 is recommended.
The nasal cavity and maxillary sinuses are partially imaged. Slight mucosal thickening is noted on the antral floor bilaterally. The antral floor is continuous.

Image 1.
Panoramic reconstruction

Image 2.
Cross-sectional, coronal and axial slices.
The UR2 is endodontically treated and shows a large, well-defined, round, periapical radiolucency of approximately 10mm in diameter

Image 3.
Cross-sectional images at 2 mm interval. The nasopalatine canal is arrowed.
The lesion envelops the apical third of the UR2 root and abuts the roots of the UR3 and UR1 in the apical third