Differential interpretation of a radiolucent lesion in the mandible: a case report

Abstract

Periapical and panoramic radiographs are essential for detecting pathological changes in dental and bone structures, particularly in identifying mandibular radiolucent lesions. This study reports a clinical case of a radiolucent lesion associated with an impacted tooth 38, discussing diagnostic hypotheses such as dentigerous cyst, odontogenic keratocyst, and unicystic ameloblastoma. The patient, initially asymptomatic, did not adhere to the recommended treatment, resulting in significant lesion progression after five years. Conservative surgical intervention was performed with clinical follow-up.The differential diagnosis of mandibular radiolucent lesions is challenging due to the radiographic similarity among entities such as dentigerous cysts, odontogenic keratocysts, and ameloblastomas. Conventional radiographs are useful for initial assessment, while cone-beam computed tomography provides greater accuracy in defining lesion limits and characteristics. In this case, the absence of symptoms and treatment delay contributed to lesion progression, reinforcing the importance of early diagnosis, multidisciplinary evaluation, and patient adherence to therapy. The case highlights the importance of early diagnosis, accurate radiographic interpretation, and adherence to the therapeutic plan to prevent anatomical and functional complications.

Keywords: Mandible, Panoramic Radiography, Odontogenic Cysts, Differential Diagnosis, Ameloblastoma.