PMC9287005_01
Clinical photographs of case 1: (a) frontal view, (b) right maxillary view showing the ulcer, (c) palatal view, and (d) right maxillary view showing normal gingiva.
CRID2022-1976352.001.jpg
PMC9287005_01_CRID2022-1976352.001.jpg
fig1
The pulp tests did not result in response on the cold and electronic pulp tester (Figure 1).
OPG of case 1 obtained at 15 days' gap.
CRID2022-1976352.002.jpg
PMC9287005_01_CRID2022-1976352.002.jpg
fig2
Multiple periapical radiographs revealed intracanal medicament in other canals that seemed empty on OPG (Figure 2).
3D CBCT view of case 1 showing resorption over the maxillary alveolus region on the right side.
CRID2022-1976352.003.jpg
PMC9287005_01_CRID2022-1976352.003.jpg
fig3
Axial views revealed full haziness in the right maxillary sinus, as well as a moth-eaten aspect to the right maxilla (Figures 3 and 4).
CBCT of case 1: (a-c) axial views; (d) cross-sectional view. (a) Osteolytic change in the posterior area. (b) Radiopaque obturating material in maxillary anterior teeth with resorption of alveolar process. (c) Haziness in the maxillary sinus on the right side. (d) Osteolytic changes on the palatal alveolar region on the maxillary 1st molar.
CRID2022-1976352.004.jpg
PMC9287005_01_CRID2022-1976352.004.jpg
fig4
Axial views revealed full haziness in the right maxillary sinus, as well as a moth-eaten aspect to the right maxilla (Figures 3 and 4).
PMC9287005_02
Clinical picture of case 2 showing yellowish pus discharge apical to the maxillary 1st premolar.
CRID2022-1976352.005.jpg
PMC9287005_02_CRID2022-1976352.005.jpg
fig5
OPG of case 2.
CRID2022-1976352.006.jpg
PMC9287005_02_CRID2022-1976352.006.jpg
fig6
CBCT scan was obtained to evaluate the 3-dimensional alterations in the maxillary region (Figure 6). CBCT indicated significant osteolytic alterations in the front maxilla, as well as the involvement of the right maxillary sinus and bony sequestrum.
CBCT axial views of case 2 showing gross osteolytic changes with bony sequestrum with haziness on the right maxillary sinus.
CRID2022-1976352.007.jpg
PMC9287005_02_CRID2022-1976352.007.jpg
fig7
The patient refused surgical therapy in favor of medicinal treatment (Figures 7 and 8).
CBCT sagittal and coronal views of case 2 showing bony sequestrum with gross osteolytic changes infiltrating the floor of the maxillary sinus.
CRID2022-1976352.008.jpg
PMC9287005_02_CRID2022-1976352.008.jpg
fig8
The patient refused surgical therapy in favor of medicinal treatment (Figures 7 and 8).
PMC9287005_03
Clinical photograph of case 3 showing multiple swellings apical to the maxillary right lateral incisor and maxillary canine, with palatal swelling indicated with an arrow.
CRID2022-1976352.009.jpg
PMC9287005_03_CRID2022-1976352.009.jpg
fig9
From the tooth number 4 through 8, there was grade 1 mobility with soft swelling in the palatal region not crossing the midline (Figure 9).
CBCT images of case 3 showing (a, b) axial views with osteolytic changes in the alveolus and palate with perforating sinus floor as seen in coronal views and sagittal views (c, d).
CRID2022-1976352.010.jpg
PMC9287005_03_CRID2022-1976352.010.jpg
fig10