PMC4073451_01
(a) The initial panoramic radiograph showing multilocular radiolucency well-circumscribed associated with impacted teeth, involving ramus and angle of mandible, (b) The oblique of mandible and, (c) panoramic, radiograph at 28 months after the surgery revealing radiolucency in posterior region of mandible. (d) The computerized tomography image showing the presence of two parallel hyperdense lines in posterior region of right body of mandible, compatible with bifid mandibular canal
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F1
In April of 2008, a 14-year-old girl was referred to department of Surgery and Oral Pathology to investigate a multilocular radiolucent lesion involving body and ramus of right mandible that was discovered, incidentally, in orthodontic documentation [Figure 1a]. The patient was lost to follow-up returning in October of 2011, during which an oblique mandibular radiograph was done, revealing a small radiolucent lesion with radiopaque borders in same region of the keratocystic odontogenic tumor [Figure 1b]. It was confirmed on panoramic radiograph [Figure 1c]. Moreover, two parallel hyperdense lines in posterior region of right body of mandible were seen, compatible with bifid mandibular canal [Figure 1d].
Multislice computerized tomography at the angle of mandible region revealing bifurcation of mandibular canal with direction ascendant and lingual
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F2
In addition, a multislice CT scan was performed which revealed an ascendant bifurcation of the mandibular canal from nearly the angle to the superior border of mandible, surrounding the bone repair, simulating sclerotic margins of a possible recurrence [Figure 2].