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Case of the Month – March 2020

By Dr Yastira Lalla

History:

Mobile teeth with signs of root resorption

Imaging:

CT Dentascan

Findings:

General appearance was of an aggressive and infiltrative process, consistent with malignancy. The Quadrant Two premolars, 26 and 27 were floating with signs of ragged root resorption in relation to all of these teeth. There was effacement and destruction of the buccal and palatal cortices of the left posterior maxilla as well as the floor and lateral wall of the left maxilla and nasal fossa.

Posteriorly bony destruction extended into the left pterygoid plates and postero-lateral wall of the left maxillary sinus with infiltration of the post antral fat plane and destruction of the left pterygo-maxillary fossa. Laterally there was involvement of the antero-lateral wall of the left maxillary of the left maxillary sinus and zygomatic buttress. Superiorly bony destruction involved the right infra-orbital rim.

Differential Diagnosis:

Squamous cell carcinoma, adenoid cystic carcinoma, histology pending.

Summary:

Floating teeth is a concerning radiological finding which indicates rapid bone erosion. This coupled with ragged root resorption as well as the other features indicated an aggressive and infiltrative process.

 

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