History of the present illness

This is a 29-year-old white male referred by his general dentist for a swelling distal to tooth # 32. It was of unknown duration and the patient reported pain in the area. The size of the lesion was about 4 cm at its greatest dimensions. Panoramic radiograph showed a well-demarcated lesion of mixed bony origin with a radiopaque mass in the center and a prominent radiolucent rim at the periphery (Figure 1). Although closely associated, this lesion was clinically separate from the impacted tooth #32.

Figure 1 Panoramic view at first presentation demonstrating impacted tooth #32 associated with a well-demarcated radiolucent/radiopaque mass giving the impressing of pushing tooth #32 inferiorly.