Use of Cone-beam Computed Tomography as a Critical Component in the Diagnosis of an Infected Nasopalatine Duct Cyst Mimicking Chronic Apical Abscess: A Case Report |
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Authors: | Dan Henry Levy Noam Dinur Talia Becker Hadas Azizi Joe Ben Itzhak Michael Solomonov |
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Affiliation: | 1. Department of Endodontics, Israel Defense Forces Medical Corps, Tel Hashomer, Israel;2. Department of Oral Medicine, Israel Defense Forces Medical Corps, Tel Hashomer, Israel |
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Abstract: | Nasopalatine duct cysts (NPDCs) and other nonodontogenic lesions of the oral cavity may mimic odontogenic pathoses. We present a case of a 22-year-old man with a history of dental trauma and a lesion displaying the typical clinical and radiographic signs of a chronic apical abscess— a buccal sinus tract that was traced to a radiolucent area in the periapex of a maxillary central incisor. A comprehensive diagnostic process that included a cone-beam computed tomographic scan and a histopathologic examination of the lesion after complete enucleation led to the final diagnosis of an infected NPDC. The adjacent tooth was vital at the 1-year posttreatment follow-up, and a radiograph demonstrated complete healing of the periradicular structures. This case demonstrates the ability of NPDCs to present clinical and radiographic signs similar to apical inflammatory lesions and the need for a meticulous diagnostic process in order to avoid unnecessary endodontic intervention. The article also discusses the differential diagnoses of nonodontogenic lesions in the premaxillary area. |
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Keywords: | Apical abscess cone-beam computed tomography nasopalatine duct cyst |
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