Case 13
### Analysis
- ==Lesion Description:==
- A round, soft tissue density superimposed over the sinus.
- The lesion has elevated and displaced the sinus floor.
- Location: Mesial to the 18, extending to the periapical region of the 17 and 16.
- There is possible communication with the oral cavity.
- ==Mandibular Observations:==
- ==Condyles: Both condyles are very small (hypoplastic) with minimal condylar neck. The left side is flattened, while the right side remains somewhat round.==
- ==Mandible: Hypoplastic mandible (both hemi-mandibles are very small).==
- ==Occlusion: Potential anterior open bite with posterior contact only, which is associated with the mandibular hypoplasia.==
- ==Sinus Observations:==
- The left maxillary sinus is very small (hypoplastic), sitting at or slightly above the level of the nasal floor/hard palate.
- This is noted as a developmental finding rather than a pathologic one.
### Differential Diagnosis
- ==Dentigerous Cyst:==
- The primary differential.
- Large dentigerous cysts can "fold over" the tooth.
- Communication with the oral cavity may disrupt its natural characteristics.
- ==Odontogenic Keratocyst (OKC) / Odontogenic Parakeratosis:==
- Often associated with impacted teeth.
- Usually a pericoronal lesion but can occur in any part of the tooth.
- Considered less common than a dentigerous cyst.
### Diagnosis
- ==Primary Finding: Large cyst related to the 18 (most likely a dentigerous cyst).==
- ==Secondary Findings:==
- Hypoplastic mandible and condyles.
- Hypoplastic left maxillary sinus.