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Mandibular osteomyelitis

Findings:
Horizontally impacted left lower third molar, associated with osteolysis area bounded by reactive osteosclerosis, open on the vestibular surface with some bone seizures in context. No associated soft tissue swelling.
The inferior alveolar nerve canal courses along the posterolateral and inferior aspect of the lesion with focal area of dehiscence of the canal.
Periapical radiolucencies are noted surrounding the root of the right upper and lower third molars, in keeping with apical periodontitis.
Buccoangularly impacted left upper third molar, partially protruding into the left maxillary sinus.

Minimal mucosal thickening is seen within the maxillary and ethmoid sinuses. The nasal cavities are unremarkable.
The mastoid air cells and middle ear cavities are clear.
Moderate to high-grade degeneration of the imaged cervical spine is seen.

Conclusion:
Chronic mandibular osteomyelitis associated with horizontally impacted left lower third molar, as described above.
Apical periodontitis at the apex of the right upper and lower third molars.

Updated on 25. May 2023

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