Solitary bone cyst in the anterior mandible.

Solitary bone cyst is relatively rare in oral surgery. Although BEASLEYM reported that solitary bone cyst in the jaw was more common than previously believed, its incidence of occurrence is still very low. Because they are generally asymptomatic, most cases are only incidentally discovered through routine radiography. Accordingly, any increase in the occurrence of solitary bone cyst would mostly be accounted for by the development of radiographic techniques, especially the common use of panoramic radiography. Clinically, solitary bone cyst of the jaw is reported most frequently in the posterior portion of the mandible. We report here a relatively rare case of a solitary bone cyst in the anterior mandible. Case report In September 1985, a 22-year-old woman was referred by a dentist for diagnosis and treatment of a radiolucent area in the mandible. The lesion had been incidentally found by routine radiographic examination. The patient was asymptomatic and had no history of trauma to the jaw. Family and medical histories were not contributory. There was no visible swelling over the root apex area of the left cuspid, no expansion of the cortical plate, and no paresthesia over the mental region. Palpation also elicited no pain. There was no loosening of the involved tooth (left cuspid), which was vital to pulp testing. The panoramic radiograph showed a well-circumscribed radiolucent area approximately 2.5 cm in diameter, at the apical area of the mandibular left cuspid (Fig. 1). The periapical film showed more defined radiolucency than that of the panoramic radiograph (Fig. 2). Although the margin was irregular, no scalloping was found. The lesion involved the apex of the cuspid, but no evidence of root resorption was found. All screening laboratory findings were within normal limits. An aspiration biopsy was attempted, but the cortical bone could not be perforated with the needle, so an incisional biopsy was performed. An approximately 10-mm section of overlying