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Case 208189

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Referral category

Disease / syndrome / tumor / condition

Region of interest

31-41

Referral reason

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Canaray 208189

1. Benign cyst or cystic tumor in anterior mandible

A well-defined, partially corticated, unilocular radiolucency is present in the anterior mandible adjacent to teeth 31 and 41. The buccal and lingual cortical plates are partially dehiscent adjacent to this defect, and the alveolar crestal bone is lost. The lesion extends along the lingual aspect of the entire length of the root of tooth 31, and the contiguous lingual cortical plate is thinned and expanded. The roots of teeth 31 and 41 exhibit external resorption adjacent to this area of intraosseous pathology, and the roots also appear to be mildly splayed. No signs of periapical pathology are noted.

This appearance is most consistent with a benign cyst or cystic tumor in the anterior mandible. The extent of external resorption associated with teeth 31 and 41 suggests this may reflect either a central giant cell granuloma or an ameloblastoma. The diagnosis of a giant cell tumor in an adult patient would necessitate ruling out the presence of hyperparathyroidism. However, a biopsy and histopathologic evaluation is required for a definitive diagnosis.

Orthogonal views of tooth 41

These orthogonal cross sectional images demonstrate the presence of external resorption along the mesial aspect of the middle third of the root of tooth 41. No direct pulpal communication is noted. The root apex of tooth 41 is malformed and exhibits a dilaceration, but no signs of endodontic pathology are noted.

Orthogonal views of tooth 31

These orthogonal cross-sectional images demonstrate external resorption along the mesial aspect of the coronal and middle thirds of the root of tooth 31. This area of resorption closely abuts the root canal system, but no signs of endodontic pathology are noted at this time.