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.