History of the present illness

This is a 54-year-old white male who was referred to the Department of Oral Surgery, UW SOD for a swelling in the right mandible involving teeth #s 29-32. The panoramic radiograph demonstrates a large and well-defined unilocular radiolucency in the right posterior mandible of 1.5 to 2.0 cm in size (Figure 1). Distal to the large radiolucency and below the inferior alveolar canal is a much smaller round radiolucent lesion. The large lesion was buccally expansile and the lesion had perforated the buccal plate. There was little to no lingual plate in that area. Both teeth #s 30 & 31 showed evidence of resorption. The mesial root of tooth #31 was sharply resorbed.

Figure 1 Panoramic radiograph taken at first clinical presentation. Note the large, well-defined radiolucency involving area of teeth #s 29-32. Also note a small and round radiolucency distal and inferior to the large lesion and below the inferior alveolar canal.