2. Case Presentation
2.1. History and Clinical Examination
A 38-year-old female reported to an outside private dental practice
office with chief complaint of pain and discomfort on her left anterior
mandible region 1 year prior to presentation to our office. Initial
orthopantomography (OPG) was obtained and a radiolucent lesion measuring
15 x 10 mm surrounding the roots of mandibular left lateral incisor and
left canine was noticed (Figure 1). The lesion was hurriedly and
erroneously diagnosed as a radicular cyst without conducting any further
pulp vitality tests and the two above-mentioned teeth were
endodontically treated. A few months subsequent to the initial root
canal treatment, the pain did not subside and the no change in the size
of the radiolucent lesion was obtained, therefore and left mandibular
central incisor was endodontically mistreated additionally without yet
again conducting any further pulp vitality tests. These sequelae of
mistreatments and persistent pain and discomfort following a third root
canal treatment, forced the patient to be referred to our oral and
maxillofacial surgery private office. There were no significant issues
in the patient’s medical history upon presentation.
Clinical examination revealed a mild, diffuse enlargement extending from
the left mandibular first premolar to the right mandibular canine
anteroposteriorly and slightly buccolingually. Overlying skin on the
mental region was normal and devoid of any ulcerations, erythema, and
rise in temperature. Intraoral examination did not reveal any breach in
the mucosa and the integrity of it remained intact. On palpation of the
oral mucosa, the enlargement was bony hard on lingual cortex but with a
doughy consistency on buccal plate suggesting destruction of the buccal
cortical plate, diffuse and non-tender. Moderate mobility of five teeth
including mandibular right lateral incisor to left canine was evident on
palpation.