PMC3304240_01
Facial swelling on right side of face leading to slight facial asymmetry
NJMS-2-73-g001.jpg
PMC3304240_01_NJMS-2-73-g001.jpg
F1
On extra-oral examination, swelling was evident on right side of the face leading to slight facial asymmetry [Figure 1].
Enlargement of the posterior maxilla caused by the lesion
NJMS-2-73-g002.jpg
PMC3304240_01_NJMS-2-73-g002.jpg
F2
Patient presented with adequate mouth opening and intraoral examination revealed swelling of size approximately 2 x 2 cm distal to 16 with buccal as well as lingual expansion and indentation imprint of lower molar [Figure 2].
Panoramic radiograph showing a large well-defined homogenous radiopaque mass distal to tooth 16 and coronal to 17 with radiolucent margin
NJMS-2-73-g003.jpg
PMC3304240_01_NJMS-2-73-g003.jpg
F3
Panoramic radiographical examination [Figure 3] revealed a well-defined homogenous radiopaque mass distal to the tooth 16 and coronal to un-erupted tooth 17 with radiolucent margin.
(a) Axial, (b) coronal, (c) saggital CT scan view showing a mixture of radiolucency and radiopacity along with the sclerotic border
NJMS-2-73-g004.jpg
PMC3304240_01_NJMS-2-73-g004.jpg
F4
CT scan [Figure 4a-c] showed a well-circumscribed and sharply defined lesion consists of a mixture of radiolucency and radiodensity with sclerotic border.
Photograph after reflection of flap showing the lesion and extreme buccal as well as superior displacement of tooth 17
NJMS-2-73-g005.jpg
PMC3304240_01_NJMS-2-73-g005.jpg
F5
Tooth 17 was also extracted during the procedure because of its extreme buccal malposition [Figure 5] and to facilitate the complete enucleation of the lesion.
(a) Mesial and (b) buccal view of tooth 17 showing root dilacerations
NJMS-2-73-g006.jpg
PMC3304240_01_NJMS-2-73-g006.jpg
F6
The extracted 17 was presented with root dilacerations with its palatal root curved sharply in the palatal direction while mesiobuccal and distobuccal roots curved distally [Figure 6a and b].
Excised specimen showing a well-circumscribed tumor that shelled out in in one piece
NJMS-2-73-g007.jpg
PMC3304240_01_NJMS-2-73-g007.jpg
F7
Grossly, the specimen was a well-circumscribed mass measuring about 2.5x2.2x1.6 cm [Figure 7] with areas of hardness.
Radiograph of specimen showing mixture of radiopacity and radiolucency in the central region
NJMS-2-73-g008.jpg
PMC3304240_01_NJMS-2-73-g008.jpg
F8
Radiograph of the excised specimen revealed radiolucency in the peripheral region and mixed radiopacity and radiolucency in the central region [Figure 8].
(a) Photomicrograph showing trabeculae of woven bone in a background made up of dense mature collagen fibers (H and E, x4), (b) High-power view showing woven bone rimmed by plump osteoblasts (H and E, x40).
NJMS-2-73-g009.jpg
PMC3304240_01_NJMS-2-73-g009.jpg
F9
The hard tissue was present in the form of trabeculae of mature lamellar bone, immature woven bone and areas of unmineralized osteoid [Figure 9a]. The trabeculae of woven bone and osteoid showed brush border at the periphery and were lined by plump osteoblasts [Figure 9b].