Cone Beam Computed Tomographic findings in Unicystic Ameloblastoma of the mandible.

Abstract

Ameloblastomas are one of the commonly encountered odontogenic tumours (1). Ameloblastomas are of the following types namely peripheral, solid or multicystic, unicystic, desmoplastic, and malignant (1,2). Unicystic ameloblastoma is a rare variant of ameloblastoma and accounts for around 6% of all ameloblastomas (1). Clinically and radiographically, it resembles a cyst but on histopathological examination has features of ameloblastoma (1). Cases with multilocular radiolucency and histopathology of unicystic ameloblastomas were earlier termed as cystic ameloblastomas. However, this term is no longer used; instead, the lesions are termed as unicystic ameloblastoma (1). The present case describes unicystic ameloblastoma of the posterior mandible in a 42 years old male patient. A 42 years-old-male reported to our department with complaint of pain in the lower left back tooth region last 15 days. He gave history of a fall two weeks previously followed by continuous, throbbing, diffuse pain in the area of the lower jaw and on the right side of the face, radiating till the right ear. There was mild swelling and difficulty in eating and wide opening of the mouth. He consulted a dental practitioner who prescribed antibiotics and advised a panoramic radiograph. Panoramic radiograph showed a well-defined radiolucent lesion approximately 2x4 cms in size located distal to the mandibular left third molar. He was then referred to our institution.Extraoral examination showed no abnormalities. On intraoral examination, a bluish white swelling approximately 1x1cms in size was present from distal and lingual to the crown of the mandibular left third molar. On palpation, the swelling was soft in consistency and non-tender. The third molar appeared to be displaced buccally due to the swelling ( Figure 1A). The second and third molars were vital on electric pulp testing. Panoramic radiograph showed a well-defined radiolucency approximately 3x4 cms in size distal to the mandibular left third molar. Superiorly the radiolucency extended to the alveolar crest and inferiorly, it surrounded the distal root of the third molar with evidence of root resorption. Medially the swelling was along the distal surface of the third molar and laterally extended around 4 cm distal to the third molar. There were no calcifications or loculations within the radiolucency ( Figure 1B).