Mandibular Osteolytic Lesion in Adolescents: A Dentigerous or Radicular Cyst?

Abstract

ramus area. Somehow in this case, cyst was extending up to roots of first and second molars. Therefore, this case presents mandibular cyst with a diagnostic dilemma between a DC and a radicular cyst owing to its radiological and clinical presentation. CASE REPORTA 17-year-old female patient reported to the Department of Oral and Maxillofacial Surgery, YMT Dental College and Hospital, Navi Mumbai, Maharashtra, India, with the chief complaint of decayed mandibular first molar. The cystic lesion was found in routine radiographical investigation (Fig. 1). Obvious swelling or facial asymmetry was not noted. Neither sinus nor fistula was evident extraorally. Lymph nodes were nonpalpable, nontender regional. Examination (Fig. 2) showed grossly carious #36. By using electrical pulp testing method, #36 and #37 were found to be nonvital. The involved teeth were not mobile, and pain on percussion was absent. No paresthesia was recorded. Orthopantomogram (OPG) showed a cariously involved #36. Overretained #75 and #85 and congenitally missing #35 and #45 were seen. A large unilocular radiolucency extending from #36, #37 to unerupted 38 was observed with resorption of both the roots of #37. Well-defined, well-corticated borders were seen. Intact inferior border of the mandible was seen (Fig. 1) ABSTRACTDentigerous cyst (DC) is one of the most common odontogenic cysts that develops abnormally around unerupted maxillary or mandibular teeth. It is often asymptomatic. It is incidentally observed on dental radiography with delayed eruption of teeth, could be large, and can cause symptoms related to expansion and impingement on contiguous structures. Pain and swelling may be the major complaints of patients. However, DC rarely causes inflammation or infection. In this study, the case of a surgically managed 17-year-old female, with a suspected DC with a diagnostic dilemma between a radicular cyst and DC arising from left mandibular third molar extending up to roots of second, first molar, and an overretained deciduous second molar teeth is presented.