How to Treat?  M

A 16-year-old woman presented to clinic with parents for orthodontic treatment for crowding (Fig.1).  How to treat the case with radiopaque lesion between LR 4 and 5?

I am not sure what that is between the roots of the 2 teeth, but I would refer to the OS.  It may very well prevent the alignment and root paralleling in that area
Tim Thursday, January 30, 2020, 11:36:37 PM EST

Thanks for the suggestion. My original idea is to extract 4s and use trephine bur in LR4 socket to harvest distal bony tissue for biopsy, which is the least traumatic. The worst scenario is self drifting of the remaining dentition.

CT is taken 4 months post panoramic X-ray (Fig.2).  C: coronal; S: sagittal; A: axial; B: buccal.  Coronal (Fig.6) and sagittal (Fig.7) sections.  It seems that the lesion does not invade the thin buccal plate or the periodontium.

Return to Professionals  Xin Wei, DDS, PhD, MS 1st edition 01/30/2020, last revision 02/01/2020