Cone beam computed tomography in the detection of reactional osteogenesis of the maxillary sinus: a case report

This report describes a case of reactional osteogenesis associated with the residual roots of the maxillary left first molar (tooth 14) in a 42-year-old woman. During intraoral examination, an extensive carious lesion was observed in the residual roots of tooth 14. On the periapical radiograph, a radiolucent area with well-defined limits and regular shape was observed in association with these roots. The 3-dimensional cone beam computed tomographic evaluation revealed that the hyperdense mass was homogenous, not corticated, of defined limits, and irregular in shape and had the density of bone tissue. The mass was clearly associated with an inflammatory periapical lesion. In this clinical case, volumetric analysis established a diagnosis of reactional osteogenesis and facilitated removal of the focus of infection associated with its development. Three-dimensional examination of possible changes in the maxillary sinus is crucial when infectious processes are present in the posterior region of the maxilla.