The case CT Dent has chosen to share this month demonstrates how CBCT scanning can be useful for demonstrating dento-alveolar pathology.
Report: full radiology report
CBCT scanner: I-CAT
CBCT imaging protocol: 80mm x 80mm single jaw maxilla
Effective dose: 0.032mSv (equivalent to two digital orthopantomogram (OPG) in radiation)
Clinical info and relevant history: alleged assault, resulting in avulsion of UL2 and luxation of UR1, UL1. Scan to determine extent of damage to buccal plate and to aid diagnosis of root fractures for implant planning.
Radiographic impression: a localised fracture of the alveolar crest was noted in the maxillary left central and lateral incisor regions. Radiographic evidence of root fracture was not identified.
The following are selected images from the volume illustrating major findings:
Reconstructed panoramic radiograph
The maxillary right lateral incisor exhibits an intact labial cortical plate and normal appearing PDL space.
The maxillary right central incisor appears to exhibit an intact labial cortical plate: the arrow indicates a
potential lateral canal adjacent to the apex the tooth and does not appear to represent a fracture.
A fracture of the maxillary alveolar process/crest was observed immediately adjacent to the maxillary left central incisor (arrows). The PDL space of the left central incisor appears widened consistent with reported history. Radiographic evidence of root fracture was not identified
The maxillary left lateral incisor region appears to exhibit mild interruption of the labial and lingual cortical plates suggestive of a line of fracture; bone fragments do not appear to be displaced
The maxillary left canine does not exhibit radiographic evidence of fracture. The PDL space appears to be normal