This paper reported a case of fusion between an impacted third molar and a supernumerary tooth, in which a surgical intervention was carried out, with the objective of removing the dental elements. The panoramic radiography was complemented by the Donovan's radiographic technique; but because of the proximity of the dental element to the mandibular ramus, it was not possible to have a final fusion diagnosis. Hence, the Cone-Beam Computed Tomography-which provides precise three-dimensional information-was used to determinate the fusion diagnosis and also to help in the surgical planning. In this case report we observed that the periapical, occlusal and panoramic were not able to show details which could only be examined through the cone-beam computed tomography.
Adult ; Cone-Beam Computed Tomography ; methods ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Fused Teeth ; diagnostic imaging ; Humans ; Imaging, Three-Dimensional ; methods ; Molar, Third ; abnormalities ; diagnostic imaging ; Patient Care Planning ; Radiography, Bitewing ; Radiography, Panoramic ; Tooth Root ; abnormalities ; diagnostic imaging ; Tooth, Impacted ; diagnostic imaging ; Tooth, Supernumerary ; diagnostic imaging

Oral squamous cell carcinoma (OSCC) has a high incidence of cervical micrometastases and sometimes metastasizes contralaterally because of the rich lymphatic intercommunications relative to submucosal plexus of oral cavity that freely communicate across the midline, and it can facilitate the spread of neoplastic cells to any area of the neck consequently. Clinical and histopathologic factors continue to provide predictive information to contralateral neck metastases (CLNM) in OSCC, which determine prophylactic and adjuvant treatments for an individual patient. This review describes the predictive value of clinical-histopathologic factors, which relate to primary tumor and cervical lymph nodes, and surgical dissection and adjuvant treatments. In addition, the indications for elective contralateral neck dissection and adjuvant radiotherapy (aRT) and strategies for follow-up are offered, which is strongly focused by clinicians to prevent later CLNM and poor prognosis subsequently.
Carcinoma, Squamous Cell ; pathology ; radiotherapy ; secondary ; surgery ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Mouth Floor ; pathology ; Mouth Neoplasms ; pathology ; radiotherapy ; surgery ; Neck ; pathology ; Neck Dissection ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Radiotherapy, Adjuvant