Article
We highlight a case of bony trabecular pattern mimicking a peri-apical radiolucency associated with a lower third molar, illustrating the sensitivity and specificity of cone beam computed tomography (CBCT) in detecting peri-apical pathology, or the lack thereof in this case, where conventional plain film radiography may be limited or misleading.
A patient was referred to the dental hospital with a painful lower right third molar. She reported pain that had been ongoing for several years, with a recent flare up of symptoms. She described a constant, throbbing pain that kept her awake at night, which was relieved by salt-water rinses and paracetamol.
Medically she was well, other than gastric reflux, for which she was taking lansoprazole. She was a non-smoker, with occasional alcohol intake.
On examination, the lower right third molar was partially erupted, covered by an operculum, with localized mild periodontal pocketing present.
A dental panoramic radiograph was taken, showing the LR8 roots superimposed on the inferior dental canal, with a well-defined radiolucency in the region of the LR8 apices (Figure 1).
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