Clinical and Radiographic Findings

The patient reported pain and swelling in the right retromolar pad area (Figure 1) of five days' duration. The lesion developed in response to trauma. The surrounding teeth were vital. Panoramic radiograph (Figure 2) revealed a large radiolucency in the posterior mandible present directly beneath the soft tissue swelling. The bony lesion was mildly expansile but was of unknown duration.

Figure 1 This photograph was taken at first clinical presentation to the oral surgeon complaining of pain and swelling of five-day duration. Note the deeply ulcerated soft tissue swelling in the right retromolar pad area. At this point, the patient was having difficulty closing her mouth.

Figure 2 Panoramic radiograph taken at first clinical presentation. Note the large, well-defined radiolucency involving area of tooth #31 and extending posteriorly into the ramus. Also note, it is pushing the inferior alveolar canal but not arising from it.