Clinical and Radiographic Findings
The patient presented for a routine dental cleaning when this lesion was discovered as an incidental finding. The patient has all his four third molars, one erupted (tooth #1) and three impacted (teeth #s 16, 17 and 32). He also has multiple endodontically treated teeth and one four unit bridge in the posterior maxilla (Fig 1). Tooth # 17 shows a large, unilocular radiolucency with smooth and corticated borders pushing on the inferior alveolar canal and growing posteriorly into the ramus. The radiolucency surrounds the crown of tooth # 17 from the cemento-enamel-junction (CEJ) to CEJ. Despite the size of this lesion, there was no clinical evidence of significant expansion.
Figure 1. Panoramic view at first presentation demonstrating a well-demarcated, unilocular radiolucency extending posteriorly into the ramus and associated with the crown of an impacted third molar.