Triangular radiolucent lesion of the mandible

Abstract

In December 2014, a 62-year-old man sought care from his general dentist for a bulge on the lingual side of teeth nos. 21 and 22, which the patient could feel with his tongue. Although the specific duration of the lesion was unknown, the patient had been undergoing routine periodontal maintenance for 3 to 4 months during which only bite-wing radiographs were obtained, and clinical expansion was not noted during prior examinations. Periapical and panoramic radiographs of the area obtained in December 2014 revealed a well-defined radiolucent lesion between the apexes of the mandibular left canine and first premolar—teeth nos. 21 and 22 (Figures 1 and 2). Clinical examination revealed a bulge that was soft and compressible involving the buccal and lingual area of teeth nos. 21 and 22; endodontic testing indicated that the teeth were vital, and the teeth were not mobile. The patient did not report pain. Dr. Ko is a clinical assistant professor, Department of Periodontics and Oral Medicine, University of Michigan, School of Dentistry, 1011 N. University Ave., Ann Arbor, MI 48109. A.squamous odontogenic tumorB.lateral periodontal cystC.odontogenic keratocystD.ameloblastoma C.odontogenic keratocyst Lesion terminologyThe Journal of the American Dental AssociationVol. 147Issue 6PreviewDr. Eugene Ko provided an excellent case in the March JADA Diagnostic Challenge titled “Triangular Radiolucent Lesion of the Mandible” (Ko E. JADA. 2016;147[3]:192-195). This commonly encountered clinical and radiographic presentation provided an excellent opportunity to review the lesion and differential diagnosis. Although I commend Dr. Ko, I was disappointed that the opportunity to more directly educate the wide JADA audience regarding keratocystic odontogenic tumor was missed. The lesion was identified as an odontogenic keratocyst in the highlighted header at the top of the page. Full-Text PDF