A large radiolucent lesion in the right posterior mandibular region

was discovered during an annual dental check up on an 18 year-old

male. He described no pain or sensitivity in the area. He stated that he
had been hit in the face in that area while boxing. All his vitals were
within normal limits and there were no discoveries found during
Head/Neck or Intra/Extra oral exam. The lesion has been defined as an
interradicular: between the roots of the teeth, scalloping and with welldefined borders. The surrounding teeth all were vital with an intact PDL
and lamina dura.
We have concluded that the lesion seen in the radiographic is a
simple bone cyst. Our patient stated that he had some previous
trauma in the area the lesion was located. Simple bone cyst causes
are uncertain but trauma has been suggested as a reason. The
radiographic findings of the description of the lesion state the lesion is
interradical, scalloping with well defined borders and extends around
and in-between the roots of adjacent teeth. This description is
identical to the radiographic characteristics of a simple bone cyst.
Simple bone cysts are asymptomatic and discovered on routine
radiographs. The patient has no pain or sensitivity in the area of the
lesion all his vitals are within normal limits. The patient also attends
the dentist regularly and the lesion was discovered on his annual check
up.

We have determined that this lesion couldnt be an odontogenic

keratocyst because this type of cyst has a frequent reoccurrence.
There is no stated history that the patient has had any previous
radiolucent lesion discovered on his radiographic. Also the odontogenic
keratocyst is known to move teeth or resorb tooth structure, neither of
these findings was found on the radiographic of the patient. The teeth
surrounding the lesion were vital with an intact PDL and lamina dura.
This lesion could not be a primordial cyst because this cyst
occurs most commonly in place of a missing 3rd molar or posterior to
an erupted 3rd molar. One of the diagnostic tools for diagnosis this cyst
is that there is history of a tooth not being present in that area. There
is no evidence that the patient had history of a missing tooth in the
area where the radiolucent lesion was discovered on the radiograph.
The radiograph also shows that the lesion is not placed posterior to a
3rd molar.
This lesion is not an ameloblastoma because there is no
destruction or swelling of the bone identified on the patients
radiograph or clinically. Both are diagnostic tools used to identify this
lesion. Also the radiographic appearance of the lesion is not a soap-like
or honey combed radiolucency like that described of an
ameloblastoma.
A central giant cell granuloma is most commonly seen in females
than males and in the anterior segments of the maxilla and mandible.

It is very uncommon to find one of these lesions in the ramus of the

mandible. Patients with this lesion usually complain of discomfort. The
lesion discovered on the patient is in the posterior region of the right
mandibular arch, which makes it highly unlikely that this lesion is a
central giant cell granuloma. Also our patient is male and also made no
complaints of discomfort or pain in the region the lesion was located.

References
Ibsen, Olga A. C., Joan Andersen. Phelan, and Olga A. C. Ibsen. Oral
Pathology for the Dental Hygienist. St. Louis, MO: Saunders/Elsevier,
2014. 154+