A Bilocular Radicular Cyst in the Mandible with Tooth Structure Components Inside

Area of Science:

• Oral and Maxillofacial Surgery
• Dentistry
• Pathology

Background:

• Radicular cysts are the most frequent inflammatory odontogenic cysts.
• Typically, they present as unilocular radiolucencies.
• Multilocular or complex presentations are exceptionally rare.

Observation:

• A 64-year-old male presented with an asymptomatic, bilocular radiolucent lesion in the left mandible.
• Imaging revealed an 18mm x 15mm lesion involving the roots of the first and second premolars.
• The lesion exhibited knife-edge root resorption of the second premolar.

Findings:

• Surgical resection and histopathological examination confirmed a radicular cyst.
• The cyst contained tooth structure components, specifically lamellar cementum, in its proximal portion.
• The distal portion showed inflammation without any tooth structures.

Implications:

• This case highlights the potential for radicular cysts to exhibit rare morphological variations, including multilocularity and internal tooth structures.
• Accurate diagnosis requires considering differential diagnoses like ameloblastoma and odontogenic keratocyst.
• Understanding these rare presentations is crucial for effective surgical management and treatment planning in oral pathology.