This patient was seeing his dentist for a regular exam and follow-up. On a routine X-ray, a hollow and dark area was noted in the jaw bone. The patient had no symptoms or any signs of infection. He was referred to Dr. Kazemi for evaluation. A CT scan was obtained which showed a cystic cavity within the right side of the lower jaw. It was in close proximity to his lower teeth.
Initially, he was referred to see an endodontist (root canal specialist) for evaluation of the lower right teeth. This type of cyst is commonly related to infection and it is important to evaluate the vitality of the adjacent teeth. Root canal treatment is initiated if teeth are non-vital. This was difficult to assess due to crowns over the teeth. Patient then saw Dr. Kazemi to remove the cyst in the office under IV sedation. The bony defect where the cyst laid was grafted with calcified bone grafting material and the gum tissue was closed with sutures. The cystic lining was sent to an oral pathology lab for histology and diagnosis. The patient’s pain and swelling resolved over 5-7 days. The cyst was found to be in direct contact with patient’s second premolar, therefore patient was referred back to the endodontist for completion of the root canal on that tooth. The patient follow-up x-rays at 6 and 12 months show normal healing and complete regeneration of the jaw bone.