Etiology • Probably reactive or responsive in nature • Speculation suggests it may represent a developmental anomaly.
Clinical Presentation • Bony expansion • Most cases arise in those less than 30 years of age • Female predominance • Near exclusivity in mandible or maxilla; rarely in facial bones • Occurrence in mandible predominates 3:1 over that in maxilla. • Usually anterior to molar teeth • Most cases are nonaggressive, slow growing, and asymptomatic,
with no cortical breakthrough or root end resorption. • Some cases are recurrent and exhibit aggressive behavior with
pain, perforation, and rapid enlargement. • No radiographic or histologic features can be used to separate
nonaggressive lesions from aggressive lesions.
Clinical Presentation • Bony expansion • Most cases arise in those less than 30 years of age • Female predominance • Near exclusivity in mandible or maxilla; rarely in facial bones • Occurrence in mandible predominates 3:1 over that in maxilla. • Usually anterior to molar teeth • Most cases are nonaggressive, slow growing, and asymptomatic,
with no cortical breakthrough or root end resorption. • Some cases are recurrent and exhibit aggressive behavior with
pain, perforation, and rapid enlargement. • No radiographic or histologic features can be used to separate
nonaggressive lesions from aggressive lesions.
Radiographic Findings • Usually multilocular, occasionally unilocular, radiolucency • Margins are usually well defined; borders may be scalloped. • Can displace teeth; less commonly it resorbs tooth roots • Wide size variation at time of presentation
Diagnosis • Incisional biopsy • Primary hyperparathyroidism should be ruled out.
Differential Diagnosis • Odontogenic lesions
• Ameloblastoma • Odontogenic myxoma • Odontogenic keratocyst
• Nonodontogenic lesions • Hemangioma • Aneurysmal bone cyst • Traumatic bone cyst
• Hyperparathyroidism • Giant cell tumor
Connective Tissue Lesions 175
Treatment • Thorough curettage • Marginal resection, if aggressive or recurrent • Calcitonin may be successful in some cases. • Intralesional corticosteroid placement in small lesions may be
successful.
Prognosis • Aggressive variant has high recurrence rate • Generally good