15 years old girl. Got pain in lower ryt side lot f times now observing swelling from last 2 weeks. 3,4, 5 is bit mobile. On fine needle aspiration it was bony hard and nothing came out. Swelling is not present in lingual side. I am planning to go for excisional biopsy. With chemical cautrization. Let's discuss baut the diagnosis.

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Radicular cyst Dentigerous cyst Periapical abscess Root canal treatment 43,44,45 Open dressing 4 days

Either OKC or Radicular cyst or dentigerous cyst. Do biopsy. Followed by RCT of 43,44, 45.. Subsequently surgical excision of lesion. If required place PRF for accelerated bone healing. Post surgical Splinting would be required.

Do biopsy first
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Things to be done before invasive treatment- assess extent with iopa n occlusal films, tooth vitality, also check depth of penetration for aspiration as if was bony hard it wouldn't appear as a well defined r/l lesion. Looking at thickening of bone trabeculae adjacent, it seems to be reactive lesion. Try aspiration again. H/o trauma or ortho treatment to be ruled out

Yes doc I shall go for aspiration again with wider needle
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kindly do the full blood tests. any loss of sensation in lower lip? excisional biopsy and chemical cauterisation a good option.do tooth vitality test as well.if tooth is grade 3 mobile be cautious abt vascular lesion.

Till now there is no signs of paresthesia. But i have informed baut post surgical paresthesia possibilities. Teeth are grade 1 mobile still chances of ABC is the . But no history of trauma
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any history of trauma ?

do the access opening.... try biopsy of the exudates if anything comes out....
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Go for bone biopsy.... N Cbct .....okc....ameloblastoma...

Check the vitality of 3,4,5.... if required rct for those teeth...mean while incisional biopsy after reflecting the flap has to be done..before going for excision .d/d : radicular cyst, ameloblastoma, lateral periodontal cyst if the teeth are periodontally compromised...or ABC

Radicular cyst Biopsy Rct 43,44,45 Crown

sir r u suspecting okc???

No suspecting ABC
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See i think it just peri apical abscess .plan rct for 43 44 45 and put it for open dressing for 3 to 4 days and give antibiotics like agumentin and metro gal daily twice for five days it will get normal

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