History of the present illness

This is a 26-year-old Hispanic female who presented to her dentist with mild pain and very large swelling on the right posterior mandible. The area was described to be of a problem for six months, but the swelling increased tremendously within the last a few weeks. The clinical findings are those of a large submandibular facial swelling. Intra-orally (Figure 1), the swelling expands buccal and lingually pushing teeth #s 30 and 31 buccally, more so tooth #30 with extreme mobility of the two teeth. The panoramic view shows a large and expansile multilocular radiolucency extending from the apex of tooth #27 to inferior border of mandible and to the right mandibular notch. Inferior border of mandible is obscured from the multilocular appearance (Figure 2).

Figure 1 This photograph was taken at first clinical presentation. Note the buccal and lingual expansion and the redness of the mucosa and gingiva overlying the swelling. Teeth #s 30 & 31, especially tooth #31 are pushed bucally.

Figure 2 This radiograph was taken at first clinical presentation. Note the ballooning expansion and the multilocular radiolucency extending from tooth #27 anteriorly to the mandibular notch posteriorly. Also, note the resorption of teeth #s 30-32.