PMC10185418_01
(a) OPG X-ray: unilocular radiolucency surrounding the crown of the impacted second premolar tooth #35, with its crown protruding into the cystis cavity. Border of the cystic lesion is in continuity with lamina dura of the tooth #75. (b) 3D CBCT: cystic lesion in relation to other anatomical structures of the mandible. (c) CBCT: coronal view of the cystic cavity.
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Analysis of the OPG X-ray showed a round radiolucency in the left premolar region of the mandible (Figure 1(a)). Cone-beam computed tomography (CBCT) analysis showed the presence of a sizeable radiolucent lesion, its dimensions being 23.93 mm x 17.24 mm, with the cyst containing the crown of an impacted permanent tooth #35 (Figures 1(b) and 1(c)).
OPG X-ray taken during routine check-up of the patient, two years prior to the diagnosis of the cyst, showing no signs of pathology in left premolar region of the mandible at the time.
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(a) Bony defect in the body of the mandible, after cyst enucleation. (b) Enucleated cyst, containing extracted permanent tooth. (c) Repositioned flap after placing two apical mattress sutures.
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A complete cystic lining containing a permanent tooth was then sent for histopathological examination (Figure 3).
Microscopic findings of the sample Hematoxylin and Eosin (H&E). (a) Low-powered magnification (10x). (b) Cystic cavity lined by hyperplastic non-keratinized epithelium. (c) Chronic inflammatory cells in fibrous connective tissue of the cystic capsule.
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The epithelium of the luminal surface of the fibrous cystic shell was classified as hyperplastic squamous epithelium without keratinization (Figure 4).
Control OPG X-ray showing good bone healing, with no signs of relapse.
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Clinical and radiologic examination showed good bone healing, with no signs of relapse (Figure 5).