Clinical and Radiographic Findings

The clinical presentation included a progressive swelling in the left posterior mandible, which became sensitive in the last few weeks and was painful at presentation.  Pain increased with biting.  The soft tissue swelling was pink and the overlying mucosa was intact with no evidence of ulceration (Figure 1).  Radiographically, the area showed ill-defined radiolucency in the area of missing tooth #19 (Figure 2).  It was an isolated lesion.

Figure 1 Photograph taken at first clinical presentation to Harborview Medical Center.  Note the pink, sessile swelling between teeth #s 18 & 20.  Tooth # 19 is missing.  The mucosa is intact and shows no evidence of ulceration.

Figure 2 Panoramic radiograph demonstrating bone resorption, left posterior mandible in the area of teeth #s 18-20. This radiograph reveals an ill-defined radiolucency with reactive bone at the inferior margin.