Abstract

A 21-year-old male patient, on medication for schizophrenia, was forwarded from another service after an incisional biopsy that resulted in diagnosis of an odontogenic cyst. The first physical exam presented facial symmetry, satisfactory mouth opening, pain during palpation on the left lingual floor, and intraoral swelling. Orthopantogram and computed tomography revealed an osteolytic intraosseous well-defined lesion measuring about 45 × 16 × 12 mm and bone expansion located on the mandibular left side, surrounding the crown of an unerupted third molar. Due to the noncollaborative behavior, an excisional biopsy was programmed. The surgery was performed by a mandibular intraoral approach, modified sagittal split osteotomy, enucleation of the lesion, peripheral ostectomy in the surgical site, and buccal bone cortex fragment before lower left third molar extraction. The buccal cortical fragment was fixed in the original position by 2 titanium plates and 10 screws. After 32 months of follow-up there are no signs of recurrence.

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