of right rostral maxillary sinus involvement. There was alveolar bone sclerosis evident in the LeV50RtDO (D) and DV (F) views (arrows). There was no significant widening of the periodontal liga- ment space. Narrowing of the coronal aspect of the 109 alveolus was noted, which would impede oral extraction of this tooth. When the 109 crown frac- tured with forceps manipulation, a minimally inva- sive transbuccal extraction was performed with oral endoscopic and radiographic guidance.
Case 4 (Fig. 4)
Warmblood gelding, 15-year-old, with history of in- termittent left maxillary nasal discharge and sagit- tal fractures of the maxillary first molars (109, 209). Rhinoscopy of the left middle meatus revealed mu- copurulent drainage from a fistula on the medial
aspect of the left ventral conchal sinus (VCS), with exposed, necrotic bone. The left-to-right lateral view (A) reveals multiple fluid lines within paraden- tal sinus structures, but superimposition precludes identification of which side and which sinuses are involved. The DV view (B) demonstrates the sagit- tal fractures but offers little other information. The RtD30LeVO (C) demonstrates some ill-defined soft tissue and increased bony density in the left rostral maxillary sinus (RMS, arrow) apical to 209. In the LeD30RtVO view (D), there is similar fluid/ bone density apical to the 109 (arrow), and in addi- tion, there is fluid evident in the caudal maxillary sinus (CMS; arrow head). At the time these radio- graphs were obtained, 209 was extracted and the left maxillary sinus was trephined with a Stein-
