Clinical & Radiographic Findings

Clinical examination revealed mild swelling in the anterior and posterior mandible.  The radiographic findings were striking (Figures 1, 2). 

Figure 1.  Panoramic view at first presentation demonstrating a total of five cysts, area of teeth #s 1 (impacted), 16 (missing), 9-12, 17 (impacted) and 21-31.  The latter cyst is the largest and is multilocular compared to the other four unilocular radiolucencies.

There were a total of five radiolucencies: three in the maxilla and two in the mandible.  The three in the maxilla were unilocular radiolucencies around impacted tooth # 1, missing tooth #16 and between teeth #s 9 and 12. 

Figure 2.  Occlusal view of the large mandibular cyst demonstrating a multilocular radiolucency with buccal and lingual expansion. 

The two cysts present in the mandible were a unilocular radiolucency with a scalloped border, associated with tooth # 17 and extending into the ramus; and a large multilocular radiolucency between teeth #s 21 and 31. The large cyst hollowed more than two thirds of the mandible.  A sixth cyst developed within the first year of presentation in the area of impacted tooth #32.