What’s your diagnosis doctor?

One of the most enjoyable aspects of online discussion forums is critical thinking and treatment planning. I’ve tried a number of “ploys” to encourage comments, but I think this one should be the ticket…..

Please review the posting, the images and offer your commentary as to what you feel is going on…

Hello Rooters,

This is a patiënt which I saw in october 2010, he had no pain, but from time to time some blurry liquid (no pus) drained from the tooth 3.1

I retreated both incisors, but said that surgery may be necessary.

Today he presented with the same lesion. Still no pain, and he cannot remember the last time he had some drainage.

Percussion –

Probing: no abnormal deep pockets

41, 42 and 33 test normal to sensibility tests

Biting: no problem

I suspect this to be a cyst instead of a granuloma.

But what type of cyst? Odontogenic keratocyst?

Or would you think of a tumor?

And what would your planning be in this case?

Mine would be:

– Surgery

– Excavation of the tissue

– No apex resection

– histopathologic exam of the removed tissue

Would you do this yourself or would you refer to an  OMFS?

Kind regards,



Rafaël Michiels


Parklaan 119

2300 Turnhout 

Leopoldplein 14

3500 Hasselt



Oct 2010.jpg

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