==Joker Smile: Present due to the anchor plane being oriented downwards.==
==Airspace: No airspace visible because the tongue was not positioned on the roof of the mouth.==
==Ghost Images: A ghost image of the hyoid bone is visible on the left hand side of the mandible.==
Dental Analysis
==Tooth Count: All 32 teeth are present.==
==Impacted/Ectopic Teeth:==
3, 8 and 4, 8 are vertically impacted and associated with pericoronitis.
==Dental Anomalies:==
3, 3 is rotated and infra-occluded.
4, 4 and 1, 8 show buccal rotation.
==Dental Pathology:==
3, 7 has a restoration extending into the pulp floor.
No bone loss is noted.
==Occlusion: Occlusal asymmetry is present, with an asymmetrical deviation of mandibular teeth on the right hand side.==
Bony Structures and Pathology
==General: No abnormal radiolucencies, radio-opacities, or fractures are present. The trabecular pattern is unaltered.==
==Maxillary Sinus: Bilateral sinuses are in close proximity to the maxillary molars.==
==Zygomatic Arch: The zygomaticotemporal suture is visible bilaterally; it is a normal anatomical feature and not a fracture, though it appears distinct in this patient.==
Mandibular Asymmetry and TMD
==Morphology:==
==Left Side: The mandible is larger. The angle is very obtuse and rounded, with a loss of the antigonial notch (a normal anatomical feature). This is suggestive of left hemi-mandibular hyperplasia.==
==Right Side: The mandible is smaller. The condyle is small and tilted backwards rather than flattened. This is suggestive of right condylar hypoplasia.==
==Condylar Comparison: The left condyle appears normal and rounded at the superior point. The right condyle is smaller and tilted.==
==Symmetry: The left side is more rounded, while the right side is flattened on the condylar range and shorter than the left.==
Diagnosis and Management
==Diagnosis: Asymmetric mandible (congenital rather than traumatic) characterized by left hemi-mandibular hyperplasia and right condylar hypoplasia.==
==Referral Path:==
==Orthodontist: Initial referral should be to an orthodontist to assist in diagnosis and planning, as correction involves orthodontic treatment.==
==Maxillofacial Surgeon: For surgical correction of the bony asymmetry (orthognathic surgery).==
==Further Investigations:==
Cone Beam CT (CBCT) or standard CT scan to better visualize the bony abnormalities and asymmetry.
