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Case Report
Residual cyst with a misleading clinical and
radiological appearance
Najwa Karam, Fawzi Karam , Ibrahim Nasseh, Marcel Noujeim
1

Department of Oral and Maxillofacial Imaging, Lebanese University, School of Dentistry, Beirut, Founder and Member of the Lebanese
Society of Oral Surgery, Lebanon, Comprehensive Dentistry, Oral and Maxillofacial Radiology Graduate Program Director, University of
Texas Health Science Center, San Antonio, San Antonio, Texas, USA
1

A B S T R A C T
A case report of a 45-year-old male who presented with a deep defect in the alveolar crest at the buccal side of the upper right 1 molar
strongly suggesting a perforation of the oor of the maxillary sinus and an oro-antral communication. Clinical signs and symptoms
supported this diagnosis. After radiographic evaluation with Cone Beam Computed Tomography (CBCT), the diagnosis was shifting
away from oro-antral communication. The diagnosis of a residual cyst was established after surgical exploration and removal, and
histopathologic evaluation. The maxillary sinus membrane was intact.
st

Key words: Cone Beam CT, jaw cyst, periapical pathology, residual cyst

INTRODUCTION
Residual cysts are a part of the
inammatory group of
odontogenic cysts, which are one of the
most common osseous-destructive lesions
affecting the jaws.
[1-3]

In ammatory cysts are by far the most

common cystic
lesions in the jaws; they constitute 50 to
75% of all oral cysts,
Developmental
odontogenic cysts and in ammatory
odontogenic cysts are characterized by slow
growth and expansile tendency and despite
being entities that present a benign
biological behavior, they can reach
considerable size if they are not diagnosed
in time and treated appropriately.
[1-4]

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odontogenic cysts usually requires a

detailed analysis of
clinical, radiographic and histopathologic
ndings.
[1-6]

CASE REPORT
A 45-year-old mentally challenged male
underwent a routine clinical examination.
This examination revealed poor oral
hygiene, hence several sessions of scaling
and root planning were performed. A large
cavity that looked like a perforation was
clearly seen from the buccal side of the
crest at the level of the upper right 1st
molar tooth [Figure 1].
Surprisingly, the patient was not aware
neither disturbed by this problem even
though a putrefying mass of food was
always lling this defect. The patients past
medical history was non contributory.
~

Website:
www.joomr.org

DOI:
10.4103/2321-3841.111347

After discussing with his relatives, we

learned that his
rst upper right molar tooth was
~

Corresponding Author: Dr. Marcel Noujeim, Department of Comprehensive Dentistry, Oral and Maxillofacial Radiology Graduate Program
Director, University of Texas Health Science Center, San Antonio, San Antonio, Texas, USA. E-mail: Noujeim@uthscsa.edu
Journal of Oral and Maxillofacial Radiology / January-April 2013 / Vol 1 | Issue 1

17