History of the present illness

This is a 7-year-old female who first presented to the Center for Pediatric Dentistry with a chief complaint of pain associated with cracked tooth #D. During the oral examination to find the source of the pain, it was discovered that tooth #14 was missing while all the other three first molar teeth had erupted (Figure 1). The panoramic radiograph demonstrates an impacted tooth #14 surrounded by a large radiolucent/radiopaque lesion which was otherwise asymptomatic; there was no pain or parasthesia. Clinical examination of the area showed an expansion at the left maxilla overlying the lesion.

Figure 1 This is a panoramic view of the area taken at the initial presentation. Note the impacted/unerupted tooth #14 surrounded by a radiolucent/radiopaque lesion.