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Article: Volume 47 Number 2 Page 165 - February 2020

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  Dental Update 475: 165-169

Oral surgery:  Nasopalatine Cyst or Apical Pathology? A Diagnostic Dilemma and How to Manage It

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Abstract: Nasopalatine cysts (NPCs) present as maxillary midline radiolucencies and are the most common radiolucency of non-odontogenic origin. The proximity of these radiolucencies to the apical region of the maxillary anterior teeth may complicate diagnosis. We are presenting two cases of maxillary midline radiolucencies with a similar presentation but different diagnoses. Reaching a definitive diagnosis may be complicated, even when a detailed clinical examination has been carried out. The use of CBCT has been a valuable addition to the diagnostic armamentarium which can help clinicians reach more accurate diagnoses in such cases. A definitive diagnosis may be established following histopathological analysis, which is indicated in symptomatic cases.

Clinical relevance: This article highlights the importance of careful assessment of apical radiolucencies associated with the maxillary midline, leading to the correct diagnoses and appropriate treatment planning.

Author notes: Marialena Cresta, BDS, MFDS, Robert Philpott, BDS, MFDS, MClinDent, MRD(RCSEd), PgCAP, FHEA, Senior Clinical Lecturer in Endodontics/Honorary Consultant and Eleni Besi, DDS, MFDS(RCSEd), MSc, PGCert, MOralSurg, MDTFEd, Oral Surgery Consultant/Honorary Senior Clinical Lecturer, Edinburgh Dental Institute, Lauriston Building, Lauriston Place, Edinburgh EH3 9HA, UK.

Objective: To recognize the variety of presentations of this condition and understand how it is managed.