Clinical and Radiographic Findings

Clinical examination revealed mild buccolingual swelling in the left posterior mandible (Figure 1) but otherwise neither jaw showed evidence of any significant change. The patient presented with pain in the left posterior mandible, but the pain was related to a badly carious tooth #18 and not to the large cyst behind this tooth. Radiographic findings were striking (Figure 1). There were a total of four radiolucencies, two in the maxilla and two in the mandible. The two in the maxilla were unilocular radiolucencies around impacted teeth #s 4 and 11. One of the two cysts present in the mandible was a unilocular radiolucency with a scalloped border associated with tooth # 17 and extending into the ramus; the other was a large unilocular radiolucency associated with tooth #32. In addition, the patient shows evidence of few palmar pits (Figure 2) which are usually not common in children.

Figure 1 Panoramic view at first presentation demonstrating a total of four cysts, area of teeth #s 4, 11, 17 and 32. The cyst associated with tooth #17 is the largest radiolucency which is has a scalloped border.

Figure 2 This photographs demonstrates the presence of a few palmar pits which are usually not common in children but tend to be more evident in individuals with manual labor.