PMC4731537_01
A and B) The presence of sinus tract and swelling in the left lateral incisor and canine in the buccal vestibule and palate; C) Periapical lucency surrounding the left lateral incisor and canine; D) Persistent lesions after orthograde treatment led to periapical surgery; E) Extraction of the canine; F-I) Reoccurrence of the sinus tract and palatal swelling; J and K) Appearance of similar lesions on the right maxillary side
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F1
Also in the middle of palate a firm pediculate expansion was seen (Figures 1A and B). The images revealed periapical radiolucency and widening of the periodontal ligament (PDL) surrounding the left lateral incisor and canine (Figure 1C). However, signs and symptoms did not resolve and periapical surgery was indicated (Figure 1D).  Finally the dentist decided to extract the canine (Figure 1E). Unfortunately, after one week not only the sinus tract re-occurred on the left side of maxilla (Figures 1F to I) but also similar lesions appeared on the right maxillary posterior segment (Figures 1J and K).
A) Generalized PDL widening in anterior maxilla and sclerosis of trabecular bone; B and C) Perforation of the palatal cortex in and sequester formation
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F2
After more assessment of the radiographies the generalized PDL widening in anterior maxilla and sclerosis of trabecular bone was detected (Figure 2A).