This case report reviews the management of a large cystic lesion in the mandible that was discovered during routine exam, including diagnosis, treatment rational, and outcome.
Initially, the patient was referred to an endodontist to evaluate tooth #28 for pulp vitality. The results were not conclusive due to a full coverage crown and a non-specific response from the patient during testing with ice. The surgical plan was to enucleate the cyst and graft the defect. Under IV sedation, a full thickness flap was raised, exposing the defect. An osteotomy was performed to gain access into the lesion.
The cyst was completely enucleated. The apical aspect of the second premolar was noted to be within the cyst. The site was grafted with Bio-Oss, and the bony window was covered with GTR membrane. The flap was repositioned and closed.
The patient subsequently followed up with the endodontist to complete endodontic treatment on tooth #28. The healing was unremarkable, and, six months later, the site was healing well with no evidence of recurrence. The patient remains on recall for further evaluation.