Radiology · patient case question
On an anterior maxillary occlusal film a soft tissue shadow overlies the incisal edges. What is it most likely to be?
Patient case: Reading the panoramic film
demo: Series of radiographic interpretation items
chief: Assorted radiographic findings and technique errors from a single clinic session.
history: Several patients imaged the same morning; the films are reviewed together at the end of the day.
meds: Not applicable.
findings: One panoramic film shows the right ramus and posterior teeth appreciably wider than the left. Another shows two ring-shaped radiopacities superimposed over one maxillary sinus and three over the other, in a patient wearing earrings. A third shows a curved radiopacity in the lower field. An occlusal film shows a soft tissue shadow over the incisal edges of the anterior teeth.
Show answer and explanation
Correct answer: C. Normal anatomy, the shadow of the nose
- A. A supernumerary such as a mesiodens would be radiopaque with recognisable enamel and dentin density and a defined outline.
- B. A soft tissue calcification would be a discrete radiopacity with sharp borders, not a diffuse shadow following the contour of the nose.
- C. Correct. On a maxillary occlusal projection the tip of the nose and the nasal cartilages cast a soft tissue shadow across the anterior region. Recognising normal soft tissue superimposition prevents unnecessary investigation. Soft tissue shadows are diffuse and lack the density and defined outline of bone or tooth structure.
- D. A retained root would show tooth density, root form and often a residual canal outline.