Hyperplasia of the mandibular body: An anomaly in a developmental anomaly
A 30-year-old male reported to dental O.P. with the complaint of asymmetric appearance of the face. The swelling had been present from childhood and had become evident after puberty. Patient had no history of significant medical problems, trauma or family history of any hereditary disease.\nClinical examination revealed a diffuse enlargement of the lower one-third of the right side of the face. The enlargement was also seen to involve the lower border of the right mandible []. Intra oral examination revealed a swelling involving both the buccal and lingual aspect of the right mandible. The enlargement was more prominent on the buccal side, extending from the distal aspect of 45 to the distal aspect of 47 obliterating the vestibule. On palpation, the enlargement was bony hard in consistency. No sign of inflammation of the overlying mucosa was seen. Intra oral examination revealed an impacted 38 and missing 48 []. Furthermore, observed was that the lesion had not caused any malocclusion [].\nOrthopantamogram (OPG) revealed an increase in vertical height of the body of the right mandible of normal bone density. The ramus and condyle of the affected side were normal. An OPG taken at the age of 25 years (5 years back) and the current OPG showed the lesion was stable [].\nComputed tomography (CT) axial image revealed a solitary well-defined homogenous mass seen on the right body of the mandible measuring around 2 cm × 3 cm with uniform radiopacity. Bony enlargement was seen on both buccal and lingual side, buccal aspect being more prominent than the contralateral side. The bony enlargement can be well-appreciated in three dimensional (3D) CT. Furthermore observed in the radiographs, the enlargement was restricted to the body and did not extend to the condyle, which later aided in the diagnosis [].\nThe histopathology showed compact bone and numerous, small marrow spaces. The compact bone exhibited reversal and resting lines with osteoblastic rimming. Osteocytes could also be seen entrapped within the bone [].\nBased on the clinical, radiographic and histopathologic findings the diagnosis of hyperplasia of the right mandible was given.