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History Matters

History information seeking from a patient is of utmost importance. Why? An example is illustrated here. This is a radiograph that shows some type of radiopaque lesion surrounded by radiolucency (transparent on x-ray) in the area of the third molar. Osteomyelitis, a fulminate infection of the medullary compartment of the mandible, may resemble similar radiographic findings as can the very dangerous Osteosarcoma, a malignant bony cancer. This patient noted that they had some type extraction of the lower third molar in the past but the whole tooth was purposely not removed. The patient is most likely described a Coronoidectomy of the the third molar, a common procedure that is performed more often now to prevent nerve damage from the extraction of a third molar that is close to the proximity of the inferior alveolar nerve. Thus, the patient was assured that the radiopaque lesion is most likely the remaining roots of his third molar.

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