Stafne's bone cavity – unusual presentation in the anterior mandible

A 55-year-old male was referred to the Oral and Maxillofacial Surgery (OMFS) Department at St George's Hospital by his general dental practitioner for further investigations of an incidental finding of a radiolucency of the anterior mandible. The patient's medical history was unremarkable; he was a non-smoker and revealed no history of previous facial trauma or surgery. Initial examination revealed a moderately restored adult dentition with average oral hygiene. There was neither pain nor swelling of the buccal and lingual sulci of the mandible, and no cervical lymphadenopathy. All teeth were vital, non-mobile, not tender to percussion and no caries was identified.

An orthopantomogram (OPG) showed a well-defined, unilocular radiolucency below the apices of an unrestored and non-carious lower left first premolar (LL4). It was decided that a cone beam computed tomogram (CBCT) would be beneficial in diagnosing this lesion and in treatment planning; three-dimensional views allow an accurate assessment of size, location, and proximity to vital structures. Although not a routine imaging modality for SBC, we decided that, as we did not have a definitive diagnosis of SBC from the OPG, it would be necessary should any surgical intervention be required (Figures 1 and 2).