Treatment

Under IV sedation, the area was surgically explored.  A buccal window was created around the lower right third molar and extended anteriorly towards the lesion.  Once the lesion was entered, an empty cavity, devoid of any fluid or solid mass was discovered.  The third molar was removed and the soft tissue around the lining of the bony crypt and the follicle was curetted and submitted for histopathological evaluation.   

Incisional Biopsy

Histologic examination revealed multiple pieces of hard and soft tissue made up of ribbons of loose and vascular connective tissue with early bone formation and clusters of fibrinoid material (Figure 2).   The latter comprised a significant portion of the specimen (Figure 3).  The connective tissue was loose and vascular and was surrounded by aggregates of erythrocytes.  The bone was reparative in type with viable osteocytes (Figure 4).

Figure 2 Low power (x100) H & E histology shows multiple pieces of hard and soft tissue made up of ribbons of loose and vascular connective tissue with early bone formation and clusters of fibrinoid material.

Figure 3 Higher power (x200) H & E histology shows amorphous fibrinous material with small strands of vascular connective tissue and small fragment of reparative viable bone.

Figure 4 Low power (x100) H & E histology shows strands of loose and vascular connective tissue and clusters of fibrinous material.