History of the present illness

This is a 14-year-old Japanese male who presented with a large radiolucency associated with tooth #32 (Figure 1).  The lesion was 3-4 cm in size and was asymptomatic.  It was of unknown duration and was not expansile.  The radiograph revealed a large radiolucency with a scalloped border squeezing between the roots of teeth #s 30 & 31 (Figure 1).  In very close proximity to this radiolucency lay the crown of tooth #32 with a well-defined dental follicle.  The mesial aspect of this follicle appeared to be connected to the large radiolucency in the panoramic view but a line of separation was present in the CT scan (Figure 1). 

Figure 1 Panoramic view at first presentation demonstrates a large radiolucency with a scalloped border squeezing between teeth #s 30 & 31.  Note the coronal section demonstrating a fine line of separation between the large scalloped radiolucency and the dental follicle of tooth #32.