Ashlyn Bruno, Kim Le, & Courtney Campbell Case Study 1 Ashlyn Bruno, Kim Le, & Courtney Campbell

Case Study During an annual dental checkup on an 18 year-old male, a radiographic exam revealed a large radiolucency in the right posterior mandible. Radiographs revealed a large, solitary radiolucency with interradicular scalloping and well-defined borders

History The patient was unaware of the lesion in the right mandible. He denied any pain or sensitivity. When questioned about trauma to the area, the patient stated that he had previously sustained minor blows to the lower jaw while boxing. During dental appointment, the patient appeared to be in a general good state of health with no significant medical history. His dental history include routine checkups.

Examination The patients vital signs were all found to be within normal limits, Extraoral examination of the head and neck region revealed no enlarged or palpable lymph nodes. Intraoral examination revealed no bony or soft tissue abnormalities present. Radiographic examination revealed a solitary well-defined radiolucency appeared with interradicular scalloping and well-defined borders. The lesion appeared to extent around and between the roots of the adjacent teeth. The roots of the teeth surrounded by the lesion appeared to exhibit an intact lamina dura and periodontal ligament space. The teeth adjacent to the radiolucency tested vital.

Odontogenic Keratocyst Etiology: Remnants of the dental lamina, traumatic implantation or down growth of the basal cell layer of the surface epithelium, or reduced enamel epithelium of the dental follicle Sex: Slight predilection in males Location: Mostly in mandibular third molar regions Radiographically: well-defined, multilocular or unilocular, radiolucent lesion Treatment: Surgical excision and osseous curettage

Primordial Cyst Etiology: Remnants or degeneration of the enamel organ Age/Sex: young adults/ no sex predilection Location: Most common in place of the third molar or posterior to an erupted third molar Radiographically: well-defined unilocular or multilocular radiolucent lesion, resembles odontogenic keratocyst Treatment: Surgical removal of entire lesion

Simple Bone Cyst Etiology: Unknown, maybe from trauma Age: Mostly in young individuals Radiographically: well-defined unilocular or multilocular radiolucent lesion, shows scalloping around the roots of teeth Treatment: Curettage on the wall lining

Ameloblastoma Etiology: Benign, slow-growing, locally aggressive epithelial odontogenic tumor Age: Broad, but mostly in adults Location: Mandible: most often in molar or ramus area Maxilla: most often in molar area Radiographically: multilocular soap bubble-like or honeycombed radiolucency Treatment: Surgical removal, recurrence is common

Central Giant Cell Granuloma Etiology: Nonneoplastic, slow-growing lesion of unclear pathogenesis Age/ Sex: Mostly in children and young adults/ mostly females Location: Common in anterior segments of the maxilla & mandible Radiographically: Unilocular or multilocular, sclerotic or ill-defined borders, destructive, slow-growing, divergence of the adjacent roots Treatment: Surgical removal, occasionally recur

Based on the clinical information, following is the most likely which of the following is the most likely clinical diagnosis? Odontogenic Keratocyst Primordial Cyst Simple Bone Cyst Ameloblastoma Central Giant Cell Granuloma

References Ibsen, Olga A. C., Joan Andersen. Phelan, and Olga A. C. Ibsen. Oral Pathology for the Dental Hygienist. St. Louis, MO: Saunders/Elsevier, 2014. Pg154,155, 161-162, 234-236, 267 Nayak, M. T., Singh, A., Singhvi, A., & Sharma, R. (2013). Odontogenic keratocyst: What is in the name?. Journal Of Natural Science, Biology & Medicine, 4(2), 282-285. doi:10.4103/0976-9668.116968 Priya, K., Karthikeyan, P., & Nirmal Coumare, V. (2014). Odontogenic Keratocyst: A Case Series of five Patients. Indian Journal Of Otolaryngology & Head & Neck Surgery, 66(1), 17-21. doi:10.1007/s12070-012-0544-3 Imanimoghaddam, M., Javadian Langaroody, A., Nemati, S., & Ataei Azimi, S. (2011). Simple Bone Cyst of the Mandible: Report of Two Cases. Iranian Journal Of Radiology, 8(1), 43-46. Shoko, G., HIironori, A., Kazuya, T., Masahiro, N., Kenji, K., Akio, T., & Kimishige, S. (2015). Simultaneous occurrence of keratocystic odontogenic tumor and ameloblastoma in the mandible: A case report. Oncology Letters, 10(2), 785-789. doi:10.3892/ol.2015.3323