Odontogenic Keratocyst of the Anterior Mandible Mimicking Lateral Periodontal Cyst

Odontogenic keratocyst (OKC) is thought to be an odontogenic cyst of developmental origin that can arise at any place in the jaws, but mostly occurs in the mandibular angle and ramus area. It is clinically indistinguishable from a lateral periodontal cyst. A proper diagnosis can only be made based on histopathological examination. A 47-year-old woman presented with a gingival swelling on the inner aspect of the anterior region of the lower jaw. The swelling was of one year's duration and asymptomatic. Intraoral periapical radiograph revealed a well-defined oval radiolucency in the interradicular area of the lower left mandibular incisors. Cone-beam computed tomography revealed destruction of the lingual cortical plate. A provisional diagnosis of lateral periodontal cyst was made. The lesion was enucleated, and the bone defect was filled with advanced platelet-rich fibrin. Histopathological examination confirmed a diagnosis of OKC. Patient follow-up after three years showed no recurrence. By reporting this rare location of OKC, the authors would like to emphasize that there is a vast variety of maxillofacial bone lesions that resemble each other clinically and radiographically, and hence, a histopathological examination should be done for a definitive diagnosis.