Paradental cyst mimicking a dentigerous cyst in the mandibular third molar region: a case report

Abstract

Paradental cysts are inflammatory lesions that typically occur associated with the mandibular third molar, posing a challenge in the differential diagnosis with other odontogenic cysts. This paper describes the diagnostic and therapeutic management of a paradental cyst that was initially considered a dentigerous cyst based on its pericoronal location and radiological appearance as a well-defined unilocular radiolucency associated with an impacted tooth. A 64-year-old male patient presented with pain in the right mandibular region. Panoramic radiography and cone-beam computed tomography revealed a well-defined unilocular lesion associated with an impacted mandibular third molar, extending towards the mandibular second molar. Surgical treatment included complete enucleation of the lesion and extraction of both teeth. Histopathological analysis showed a non-keratinized stratified epithelial lining with chronic inflammatory cell infiltrate; together with the clinical and radiological findings, this allowed the definitive diagnosis of a paradental cyst. The postoperative course was uneventful, and a follow-up radiograph obtained at nine months showed early signs of ossification of the residual cavity.