Originally Posted by Bryanna

Hi Grace,

Thanks for posting the panoramic xray. I have to tell you that the alignment of your jaw with the xray machine was not in the proper position which is an unfortunately common problem seen in many dental offices. If you notice, in the upper arch it looks like you have an upside down smile line indicated by the dark black line that comes across from one corner of your mouth to the other. Anyway, this angle causes the upper maxilllary area to be somewhat skewed (ie: undiagnosable) as you can see it is very black. The posterior maxillary where your molars are is somewhat less affected by this era as far as the teeth are concerned. However, the sinus cavity is not very visible here either.

I can tell you that tooth #14 was very unhealthy/infected and appears to have some cystic activity around the roots. It is possible that this infection spread to your sinus. Whether or not there was a sinus perforation, the bacteria still could have infected the sinus. This area definitely needed to be debrided after the tooth was removed.

It would behoove you to have a periapical xray (this is a single film) of the #14 site to show a better view of the anatomy there. It may tell if there was a sinus correlation with this tooth, if there is residual granulomatous tissue (cysts), and if there is a sinus perforation.

I'm sorry to tell you all of this. I wish I could prevent these stupid mistakes from occurring. Some dentists need to be more strict not only about their own work but about the tasks that their staff perform. UGH :/

I suggest that you ask your OS to take the single xray. If he doesn't then see your GD.

Hope your mouth is feeling a bit better today... even after I gave you this crummy news!!

Bryanna