PMC6974990_01
Clinical preoperative picture showing vestibular obliteration in the left maxillary anterior region
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F1
Soft-tissue examination revealed vestibular obliteration and tenderness present in relation to left maxillary anterior teeth; however, overlying mucosa was intact with no signs of infection and sinus tract formation [Figure 1].
Panoramic radiograph with well-defined radiolucency extending from 21, 22, and 23
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F2
There was no resorption of involved teeth with the radiolucency and no involvement of maxillary sinus on the left side [Figure 2].
Multiplanar view illustration in sagittal, coronal, and axial sections from cone-beam computed tomography
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F3
CBCT multiplanar and axial sections [Figure 3], with three-dimensional reconstructed image [Figure 4], revealed solitary, oval, ill-defined, unilocular, complete radiolucency, with nonsclerotic border, surrounding the apical aspect of root of 21, 22, 23 causing complete destruction of labial plate at coronal aspect extending toward alveolar crest in 21, 22 region and superiorly leading to destruction of nasal floor, medially up to nasal septum, and distally till the distal aspect of root of 23.
Three dimensional illustration of pathology present from different views in different aspects
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F4
CBCT multiplanar and axial sections [Figure 3], with three-dimensional reconstructed image [Figure 4], revealed solitary, oval, ill-defined, unilocular, complete radiolucency, with nonsclerotic border, surrounding the apical aspect of root of 21, 22, 23 causing complete destruction of labial plate at coronal aspect extending toward alveolar crest in 21, 22 region and superiorly leading to destruction of nasal floor, medially up to nasal septum, and distally till the distal aspect of root of 23.
Interlacing strands of odontogenic epithelium in the connective tissue stroma showing plexiform pattern (H and E, x4)
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F5
Microscopic examination of the hematoxylin and eosin-stained slides reveal mature densely collagenized connective tissue stroma showing odontogenic epithelial cells forming a network of interconnecting strands [Figure 5].
Connective tissue stroma undergoing desmoplastic changes (H and E, x10)
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F6
Fibrous stoma along with blood vessels is enclosed between the network of odontogenic cells and appears to be compressing or squeezing the odontogenic cell network [Figures 6 and 7].
Desmoplastic changes at higher magnification (H and E, x40)
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F7
Fibrous stoma along with blood vessels is enclosed between the network of odontogenic cells and appears to be compressing or squeezing the odontogenic cell network [Figures 6 and 7].
Desmoplastic stroma compressing the epithelial islands (H and E, x10)
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F8
The compressed follicles are surrounded by hyalinized stroma in various areas [Figures 8 and 9].
Epithelial island showing desmoplasia (H and E, x10)
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F9
The compressed follicles are surrounded by hyalinized stroma in various areas [Figures 8 and 9].