Dental malocclusion

An eight-year-old female patient consulted the Department of Pediatric and Preventive Dentistry for dental malocclusion management.

 

The panoramic radiograph performed for the interceptive orthodontic treatment revealed a large unilocular radiolucency repressing the dental germ of the first lower-right premolar (#44), including the lower-right deciduous canine (#83), and associated with a treated root of nonvital lower-right first primary molar (#84)

 

The medical history of the patient did not reveal any specific systematic diseases or previous traumatic injuries in the affected area.

 

The extraoral examination seemed to show no abnormalities, while the intraoral examination revealed an imperceptible expansion of the buccal cortical on the alveolar ridge in relation to teeth 83 and 84.

Inspection showed a normal-looking mucosa (Figure 2). Palpation was painless with bony consistency. There was no motor or/and sensorial deficit at the orofacial structures.

 

A retro-alveolar radiograph was performed and showed a well-defined surrounded by a slight peripherical radiopaque thickening lesion apical to the lower-right first primary molar (#84) (Figure 3).

To confirm the limits of the lesion, a cone-beam computed tomography (CBCT) was requested.

The sagittal and coronal views of the CBCT revealed a 12 mm diameter well-demarcated unilocular radiolucency.

 

The lesion was identified in the right mandibular region, causing expansion of the buccal cortical with no signs of root resorption in the adjacent tooth and surrounding the crown of the unerupted first premolar (tooth 44). The first lower-right premolar germ was forced against the lingual cortical with a mesial angulation.