case_images: PMC11730012_01
case_images: (a) Occlusal view revealing vestibular and lingual volume enlargement with intact covering mucosa. (b) Persistence of deciduous teeth and displacement of Teeth 4.1, 3.1, 3.2, and 3.3. (c) Panoramic radiograph: a well-defined radiolucent extending from Teeth 3.4 to 4.5, with calcified elements within the lesion. Tooth 4.3 displaced caudally.
case_images: CRID2025-2844784.001.jpg
case_images: PMC11730012_01_CRID2025-2844784.001.jpg
case_images: fig1
case_images: Upon intraoral examination, firm swelling in the mandible was observed, extending towards both the buccal and lingual aspects (Figure 1(a)). The mucosa covering the area appeared normal (Figure 1(b)). Radiographic assessment through a panoramic x-ray (Figure 1(c)) taken in 2014 revealed a well-demarcated radiolucent area with corticated borders, extending from the periapical region of Teeth 3.4 to 4.5 and from the alveolar ridge to the mandibular base.
case_images: (a) Fragments of irregular brown-blackish fragments of tissue. A conglomerate of calcification denticle-like structures is evident. (b) (HE-4x) Connective tissue, partially covered by a lining epithelium. Calcified area within connective tissue, compatible with dentinoid, and interstitial hemorrhage areas are visible. (c) (HE-10x) The epithelium is composed of cells with cuboidal morphology and squamous features and is reminiscent of odontogenic epithelium. The basal layer displays palisading and hyperchromatism. Epithelial surface exhibits clusters of ghost cells. (d) (HE-4x) Denticle-like structures made by enamel matrix, dentin, and dental papilla tissue, surrounded by loose connective tissue.
case_images: CRID2025-2844784.002.jpg
case_images: PMC11730012_01_CRID2025-2844784.002.jpg
case_images: fig2
case_images: Additionally, whitish masses with denticle-like shapes were observed (Figure 2(a)). Within the connective tissue, deposits of calcified eosinophilic material consistent with dentinoid were present (Figure 2(b)). Clusters of ghost cells, characterized by their eosinophilic cytoplasm and central empty spaces, were also noted extending throughout the thickness of the epithelium (Figure 2(c)). Adjacent to these findings, calcified structures with denticle-like morphology were found, consisting of an enamel matrix, dentin, and a central zone resembling dental papilla and pulp tissue (Figure 2(d)).
case_images: (a) CBCT axial section: 1-year follow-up (2015). Formation of trabecular bone at the lesion periphery and significant reduction in size are observed. (b) CBCT sagittal section: 1-year follow-up (2015). Peripheral new bone formation with reduced vestibule-lingual bulging is evident. The arrow indicates the cannula system. (c) CBCT panoramic view: 9-year postsurgical intervention (2023). Formation of bone tissue without alteration. Maintained anatomical structures and no signs of recurrence.
case_images: CRID2025-2844784.003.jpg
case_images: PMC11730012_01_CRID2025-2844784.003.jpg
case_images: fig3
case_images: This decision was made after 1 year of follow-up, based on positive radiographic indicators (Figures 3(a) and 3(b)). The patient continued with regular follow-up examinations, and the most recent CBCT, taken in 2023, showed no signs of recurrence (Figure 3(c)).