An evaluation of reported cases of median mandibular cysts

All English-language reports of median mandibular cysts and one German article were carefully studied. All but three of 20 such cases were readily interpreted as being various forms of odontogenic cysts. Tissue sections of two of the three others were obtained, and it was eventually concluded that all three probably also represented odontogenic cysts. The median mandibular cyst does not appear to exist as an entity. All cysts reported as such are probably odontogenic. In previous reports on median mandibular cysts, undue emphasis has been placed on the "vitality" of adjacent teeth, as determined by thermal or electrical pulp testing. These tests are not completely reliable. Mucous cells and cilia can be found in odontogenic cysts, and consequently their presence in lesions reported as median mandibular cysts does not preclude these cysts from being odontogenic.