History of the present illness

This is a 42-year-old white male with a one-year history of an aggressive radiolucency of the anterior mandible (Figure 1) causing a sharp edge and irregular resorption of teeth #s 23 & 24. The radiolucency was well-demarcated despite the aggressive tooth resorption. The patient was advised to biopsy the area but he did not come until one year later with a larger radiolucency, still well-demarcated but with more significant tooth resorption involving teeth #s 22-25 (Figure 2). The teeth at this point were loose and there was obvious vestibular expansion which was described to be pink/purple in color. The swelling was approximately 2 x 3 cm in size.

Figure 1 This radiograph was taken in 2009 at first clinical presentation. Note the relatively well-demarcated radiolucency anterior mandible but the very sharp resorption of tooth #23 and irregular resorption of tooth #24.

Figure 2 This radiograph was taken in 2010 one year after the first presentation. Note the relatively well-demarcated but larger radiolucency in the anterior mandible with irregular and significant resorption of teeth #s 22-25.