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Case of the Month - Large cyst anterior mandible

CBCT Scanner: Instrumentarium OP300

Scanning Protocol: 8cm x 6cm FOV; 0.2 voxels

Effective Dose: 0.08 mSV

Clinical information: Large cyst anterior mandible on OPG, plan for enucleation. To understand nature of cyst and relations to lower teeth.

Radiographic Impression
A large, well circumscribed, mildly expansile area of low density/radiolucency was noted within the anterior midline extending from the right lateral canine interproximal space across the midline to the left lateral canine interproximal space. There is thinning of the labial and lingual cortical plates. A small, localized area of low density/radiolucency was observed associated with the apex of the mandibular right central incisor. Vitality testing of the tooth is suggested to rule out periapical inflammatory disease. The large lesion appears to primarily be associated with the apices of the endodontically treated mandibular right and left lateral incisors.

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The following are selected images from the volume illustrating major findings
Radiologist comment: the radiographic appearances suggestive of a large residual periapical cyst; however, the large size is uncommon and other entities that should be ruled out include: aneurysmal/traumatic bone cyst, ameloblastoma, central giant cell tumor of bone. Continued clinical evaluation and follow-up as deemed appropriate is suggested.