PMC7433957_01
OPG revealing odontogenic keratocyst in the right mandible and lateral periodontal cyst in the left mandible
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F1
There was another solitary unilocular radiolucent lesion noted on the left posterior region of the mandible situated between the roots of the canine and first premolar as shown in Figure 1.
Surgical enucleation of the odontogenic keratocyst
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F2
A modified Ward's incision was given distal to 47 and following elevation of a mucoperiosteal flap, distal bone overlying the impacted tooth was removed, and the lesion was enucleated along with the impacted tooth as shown in Figure 2.
(a and b) Surgical enucleation of lateral periodontal cyst
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F3
A crevicular incision with an anterior release was given in relation to 35-33 and following the elevation of a mucoperiosteal flap, surgical enucleation of the lesion was done as shown in Figure 3.
(a) Histopathological picture of odontogenic keratocyst - H and E show a uniform lining of parakeratinized squamous epithelium with 6-8 celllayered thickness. The basal cell layer shows palisaded layer of columnar or cuboidal cells. The lining exhibits focal separation from adjacent connective tissue at one focus. The connective tissue shows mild inflammatory cell infiltrate chiefly comprising of lymphocytes. Deeper connective tissue shows hemorrhage (hemosiderin pigment). The H and E picture is suggestive of odontogenic keratocyst. (b) Histopathological picture of lateral periodontal cyst - H and E show a welldefined cystic lumen by nonkeratinized epithelium. The epithelium in most places is thin, 1-2 cell layer in thickness. In few areas, it shows mild proliferation and edematous changes. The underlying connective tissue is highly cellular and shows infiltration with chronic inflammatory cells. The connective tissue also shows multinucleated giant cells, hyaline bodies and few cholesterol clefts, and abundant macrophages. Surface keratinized stratified squamous epithelium is also evident. The H and E picture is suggestive of lateral periodontal cyst
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F4
The specimens were sent for histopathological evaluation which revealed an OKC in the right angle of the mandible and LPC in the left body of the mandible as shown in Figure 4.