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Complex odontoma associated with dentigerous cyst in maxillary sinus: case report and computed tomography features

MA Sales*,1 and MG Cavalcanti2,3

1Department of Radiology, College of Dentistry, University of São Paulo, Lauro Wanderley Hospital, Federal University of Paraiba, João Pessoa, PB, Brazil; 2Department of Radiology, College of Dentistry, University of São Paulo, Brazil; 3Department of Radiology, College of Medicine, University of Iowa, Iowa City, USA


Figure 1
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  		Figure 1 Periapical radiograph depicting huge radiopaque mass at left maxillary molar, involving roots of first and second molars

 

Figure 2
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  		Figure 2 Panoramic radiograph depicting well-defined mass in region of left maxillary molars, associated with roots of involved teeth

 

Figure 3
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  		Figure 3 Tomographic features of complex odontoma associated with dentigerous cyst (bone window). (a) Axial view – hyperdense image at level of floor of the maxillary sinus depicting destruction of lateral and posterior walls, (b) mixed image revealing a thin halo surrounding hypodense mass causing expansion of medial wall of maxillary sinus (arrows), (c) sagittal view demonstrating involvement of orbital roof and (d) coronal view showing involvement of nasal fossae, orbital roof and ethmoidal cells (arrowheads)

 

Figure 4
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  		Figure 4 (a) Axial, (b) coronal and (c) sagittal views depicting filling of maxillary sinus with homogeneous mass (soft tissue window), involving ethmoidal sinus, extending from alveolar ridge to orbital rim. The more hypodense aspect in comparison with adjacent soft tissues is highly suggestive of an associated cystic lesion

 

Figure 5
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  		Figure 5 Top image shows the inner aspect of the maxillary sinus during surgical procedure, including two distinct lesions in the left maxillary sinus. Arrowhead, dentigerous cyst; asterisk, complex odontoma. Bottom image presents the surgical specimen showing multiple lesions

 




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