GAP Australasian-Dentist-May June 2019

Category 84 AustrAlAsiAn Dentist CASE STUDY: A 15 year old female was referred to DMDi for a Cone Beam Ct of the 12/13 region. the referrer expressed concerns regarding the position of a possible supernumerary tooth. A high resolution CBCt using a dedicated device (J.Morita A170) was performed, using a 6 x 6 cm field of view in order to fully visualise the region in a single low-dose scan. the radiologist produced the following report upon review of the DMDi imaging: Right upper quadrant anterior. 11. Present. Normal alignment. No periapical lysis or root resorption. Supernumerary tooth is identified. The root lies subjacent to the midline, and is on the palatal aspect root 11 (Fig. 1b, 2a, 3). No periapical lysis is shown. The tooth shows length 14 mm, and width 5 mm. The crown, is directed in a distal direction, and is angulated towards the floor of the nasal cavity (Fig. 1, 2c, 3b). Cervical region of this tooth lies on the buccal border, root 12 (Fig. 2b, 3a). No root resorption. 12 shows near full eruption. Supernumerary crown is shown, deep to the buccal surface of the alveolar margin, which is thinned, but intact (Fig. 3b). It shows close approximation to the root, 13 (Fig. 1, 2c, 3b). No root resorption. 13 is unerupted, mesially angulated, and the crown lies just below the alveolar margin, on the palatal aspect, cervical region 12. No retained primary dentition. 14 and 15 are present, and are fully erupted. There is slight mesial inclination to 14. No destructive lesion in this quadrant. Floor to nasal cavity, and visualised sinus plate is intact. supernumerary dentition can pose complex concerns regarding not only extraction but also orthodontic alignment and resorption abnormalities for adjacent dentition. Assessing such cases with imaging is paramount. two- dimensional imaging has long been of tremendous benefit in dentistry, and remains so to this day. However in cases where dentition position or structure must be ascertained precisely to inform treatment planning, developments in CBCt imaging allow for much greater insight. the clarity and precision of low-dose CBCt can be invaluable clinically in orthodontic cases, as well as other dental conditions. DMDi provides unique, high quality dedicated CBCt scans and reconstructions with prompt imaging and report turnarounds to enhance treatment planning and help deliver optimal patient outcomes. u Dental & Medical Diagnostic Imaging. 9/1175 Toorak Road, Camberwell Victoria 3124. Ph: (03) 9889 1771; www.dmdi.com.au Email: reception@dmdi.com.au Come and see the real thing: CBCT clearly displays supernumerary dentition lInICal Fig 3. Reconstructed 3D infero-superior (a) and axial slice (b) images: DMDI J. Morita 3D Accuitomo 170 CBCT Fig 1. Reconstructed panoramic (a) and 3D AP (b) images: DMDI J. Morita 3D Accuitomo 170 CBCT Fig 2. Reconstructed cross sectional of 11 (a) and 12 (b), and coronal (c) slice images: DMDI J. Morita 3D Accuitomo 170 CBCT