PMC4166645_01
Occlusal radiograph of the massive sialolith (arrow).
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An occlusal radiograph revealed a cylindrical radiopaque sialolith-compatible image, measuring approximately 2 x 1 cm, in the lower left canine region, confirming the diagnosis of submandibular sialolithiasis (Figure 1).
Clinical view of the sialolith after surgical removal.
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Using forceps, a 20 mm sialolith (Figure 2) was removed from the floor of the mouth.
The last panoramic radiograph previously obtained for orthodontic purposes indicating the massive sialolith (arrow).
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Surprisingly, the patient provided a previous panoramic radiograph, dating from March 2011 (Figure 3), representing the last radiographic exam for conclusion of orthodontic treatment.
An additional panoramic radiograph retrieved from the patient's file revealing no sign of sialolith formation.
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Based on the lack of early detecting the sialolith on the orthodontic radiograph, a deeper investigation in the patient's dental files was carried out revealing an additional panoramic radiograph, dating from June 2004, in which no sign of sialolith was detected (Figure 4).