case_images: PMC11068244_01
case_images: (a) Preoperative view showing asymmetry of face due to swelling, (b) Intraoral swelling present on the right side of the lower vestibule
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case_images: There were no palpable pulsations or pus discharge seen on the extra oral examination, but there was facial asymmetry due to swelling detected on the mandibular right side of the face [Figure 1a]. The swelling was painful, stable, and bone-like in texture [Figure 1b].
case_images: (a) Intra oral picture showing normal maxilla (b) Retained deciduous teeth in the mandibular anterior region
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case_images: From the first right molar through the first left molar, all of the maxillary teeth were present and intact [Figure 2a]. This caused malpositioning of 41 and crowding in the mandibular anterior region. 44 and 45 were clinically absent [Figure 2b].
case_images: Pre-operative orthopantomogram
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case_images: The roots of deciduous first and second molars have undergone resorption [Figure 3].
case_images: Computed tomography scan of face
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case_images: On the right side of the mandible, the buccal and lingual cortical plates were enlarged [Figure 4].
case_images: Red arrow indicates the window created and black circle indicates the size of the window generated as part of marsupialization.
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case_images: The cyst was completely removed through a 2.5 cm x 1.5 cm window [Figure 5], and then Carnoy's Solution was carefully applied.
case_images: Final needle aspiration cytology (FNAC) aspirate showing a high concentration of neutrophils, a low number of nucleated epithelial cells, and a high concentration of keratinocytes against a hemorrhagic backdrop
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case_images: Cytopathological examination of the aspirate revealed features typical of a keratin-filled lesion, including an abundance of neutrophils, a dearth of nucleated epithelial cells, and an abundance of keratinocytes set against a hemorrhagic background [Figure 6].
case_images: Biopsy of the patient showing the presence of a parakaratinizd stratified epithelial lining with a large columnar basal cell layer, surface corrugation, and neutrophils, lymphocytes organised against extravasated red blood cells
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case_images: Biopsy findings revealed parakeratinized stratified epithelial lining with prominent columnar basal cell layer, surface corrugation, and neutrophils, lymphocytes arranged against extravasated red blood cells, which confirmed the diagnosis of Odongenic Keratocyst [Figure 7].
case_images: Thermoplastic splint
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case_images: A thermoplastic splint was also placed over the opening to prevent bacteria from entering the cavity [Figure 8].
case_images: Orthopantomogram and computed tomography scan after 4 months
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case_images: Postoperative thickness was 6.0 mm and 4.0 mm (thickness measured in right hemimandible) [Figure 9].
case_images: Post-operative orthopantomogram after 7 months, 10 months and 1 year
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case_images: Outcome and follow-up: After a year, an OPG was performed, which indicated the typical eruptive force of 44 and 45 in the usual place, with no evidence of recurrence and the patient being asymptomatic [Figure 10].