Presentation
Swelling over left cheek for 3 months.
Patient Data
A large well-defined unilocular cyst in the body of the left hemi-mandible with minimal extension into the anterior aspect of the ramus. The lesion is of intermediate attenuation value with an average density of 25HU. Thinning of lingual cortex and erosion of buccal cortex of the body of the left hemi-mandible with extra-osseous extension into left buccal space. Mesially rotated impacted left lower third molar tooth (38) with the cyst surrounding the crown of the tooth. Anterior bony dehiscence of left inferior alveolar nerve canal by the cyst.
Another smaller unilocular cyst noted at the crown of right lower third molar tooth (48). The right lower third molar tooth is impacted as well.
Case Discussion
Unilocular cyst at mandible associated with the crown of unerupted or impacted molar tooth. The differential diagnoses include dentigerous cyst, keratocystic odontogenic tumor and unilocular ameloblastoma.
The relationship of the cysts to the inferior alveolar nerve canal should be assessed and reported. These cysts can be complicated with infection or pathological fracture.
Both cystic lesions were enucleated as well as removal of both 38 and 48 third molar teeth. The histology confirmed bilateral dentigerous cysts.
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