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The opacities superimposed over the maxillary sinuses are ghost images of the ear piercings. There are recent sockets in the 15, 12 and 46 positions. The irregular multilocular lucency apical to the 45 and edentulous 46 position is suggestive of a developing bone/odontogenic lesion. The 45 root is intact with no obvious indications of resorption. The right inferior dental canal is obscured by the altered bone pattern. There is the suggestion of a residual periapical inflammatory lesion associated with the 46 in the apical region of the 46 mesial root. Comparison with previous radiographs would be of benefit in further assessment of this region.
The maxillary third molars are impacted and the roots of these teeth appear in close relation to the floors of the respective maxillary sinuses. These teeth may be ankylosed. There is generalised loss of alveolar bone height in both arches and the presence of calculus is noted. Decay is most obvious in the 26, 27, 37 and 45.
There is pocketing posterior to the 38 crown and a history of pericoronitis or the possibility of developing odontogenic pathology in the posterior left mandible cannot be excluded.