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Case of the month - Identifying expended lesion

CBCT Scanner: Kavo OP3D

Scanning Protocol: 8cm x 6cm FOV

Effective Dose: 0.08 mSv

Clinical information: Well corticated monocular radiolucency distal to LL7, extending to the crest of the ridge and appears to displace the ID nerve inferiorly. Clinically patient has buccal expansion and has previous infection and facial swelling. Detail the extent of the lesion, including proximity to LL7 and ID nerve (whether cortex is breached).

Dental Findings:
Presence of 1.5 cm diameter well demarcated and well corticated low-density lesion associated with the distal aspect of 37, the lesion is occupying the width of the alveolar crest with mild expansion, it is in contact with the superior aspect of the mandibular canal causing inferior displacement of the mandibular canal, the superior aspect of the canal is compressed but not interrupted. The lesion is causing severe periodontal bone loss on the distal aspect of 37 extending to the apex of the tooth and also appears to be communicating with the oral cavity.

Radiographic Impression:
The lesion in the area of 37 is communicating with the oral cavity, it is also displacing and compressing the mandibular canal with thinning but not clear interruption. Severe bone loss noted on the root of 37, prognosis of the tooth is poor. The features of the lesion and the clinical history are consistent with recurrent odontogenic keratocyst.

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The following are selected images from the volume illustrating major findings