PMC5682065_01
(a) Orthopantomogram and (b) axial view of cone beam computerized tomography showing a well-demarcated radiolucent image associated with impacted teeth #22 and 23.
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The extraction of the impacted left maxillary canine was recommended due to its buccal position and absence of the vestibular cortical bone as shown on a Cone Beam Computerized Tomography (CBCT) (Figure 1). A radiolucency cyst-like was noted on the lateral incisor (Figure 1) and was diagnosed as a dentigerous cyst.
Clinical examination. (a) Extraoral view with asymmetry. (b) Intraoral view illustrating a swelling at the buccal fold.
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On extraoral examination (Figure 2), facial asymmetry was noted.  Intraoral examination (Figure 2) revealed a solitary smooth circumscribed swelling of 1.5 cm x 2 cm in size, with well-demarcated margins in the left maxillary region filling buccal vestibule.
(a) Orthopantomogram and (b) axial view of cone beam computerized tomography, showing a well pericoronal circumscribed radiolucent image associated with impacted tooth #22.
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 The axial slides of CBCT (Figure 3) showed a well-circumscribed radiolucent lesion with well-defined radiopaque border extending horizontally from maxillary midline to the distal margin of the second premolar and vertically from the nasal base to the midpart of the roots of teeth #21 and 24.
Enucleated mass with the root of tooth #22.
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The tumor was well encapsulated, and the lateral incisor was easily removed with the lesion (Figure 4).
Adenomatoid odontogenic tumor. (a) Low-power view demonstrating a capsule surrounding the tumor. (b) Higher magnification showing the duct-like epithelial structures.
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The epithelial cells may form rosette-like structures around a central space, which may be empty or contain a small amount of eosinophilic material (Figure 5).
Two weeks postop.
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The healing was controlled for three weeks (Figure 6).
Orthopantomogram 3 months after surgery.
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The control orthopantomogram on the third month (Figure 7) followed by other on six months later showed normal bone trabeculation at the lesion site without recurrence.
Axial view of cone beam computerized tomography showing the healing at the surgical site with the reduction of the bone width two years after surgery.
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An orthopantomogram and CBCT were realized two years after for control, and placing an implant at the level of tooth #22 showed a reduction in the bone width in this region with complete bone healing (Figure 8).