A 17-year-old male patient attended the oral and maxillofacial surgery clinic in King Saud University requesting extraction of all third molars. The patient’s medical history was unremarkable; he was a non-smoker and revealed no history of previous facial trauma or surgery. There was neither pain nor swelling of the buccal and lingual sulci of the mandible and no cervical lymphadenopathy. Initial dental examination revealed a minimally restored permanent dentition with good oral hygiene. A panoramic radiograph showed that all third molars were present and impacted except on the upper right side where the tooth was missing, with the lower third molars in close proximity to the inferior alveolar canals (Figure ). The radiograph was otherwise unremarkable with no signs of pathology or abnormality.\nA CBCT of the mandible was requested for further assessment of the relation and proximity of the roots to the inferior alveolar canal. A survey of the CBCT sections of the mandibular body revealed bilateral sublingual depressions inferior to the premolars and first molars extending to the inferior border of the mandible that was not seen on the panoramic radiograph.\nTo assess the depth and width of these depressions, the CBCT images were reconstructed in planes aligned with the axes of the right and left mandibular second premolars in the mesiodistal dimension, buccolingual dimension, and the coronoapical dimension. Then, linear measurements representing the width of the depressions were made along a line drawn a tangent to the heights of contours (crest of curvatures) of the lingual surfaces of the mandible superior and inferior to the bilateral depression. The superoinferior width of the depressions was found to be 2.1 cm on the right side and 2.9 cm on the left side. Linear measurements representing the buccolingual depth of the depressions were made along a line drawn perpendicular to the above-mentioned width line to the deepest point of the depression; it measured 0.59 cm on the left side and 0.6 cm on the right side. The buccolingual thickness of the remaining mandible was 0.42 cm on the left side and 0.45 cm on the right side (Figures -).\nThe diagnosis was concluded to be bilateral sublingual depressions of the mandible. It is considered a normal anatomical variation that does not require any further investigation or intervention. The incidental finding was documented in the patient dental record for future implications in case an implant placement was needed.
A 45-year-old man referred to the Department of Periodontology, School of Dentistry, Isfahan University of Medical Sciences for routine dental and periodontal examinations. The patient's medical history was not significant. He was not a smoker and revealed no history of trauma or jaw surgery. On extraoral examination, he had a normal appearance. On intraoral examination, the patient had neither any pain nor swelling on the buccal and lingual aspects of the mandible. The radiographic images showed a well-defined unilocular radiolucency below the apices of the left lateral incisor and left canine teeth [].\nFurthermore, deep caries was observed in the left lateral incisor. The clinician suspected a periapical lesion of endodontic origin, but unfortunately, the vitality test of the tooth was not done. To rule out any possible existing pathology in anterior mandible, a diagnostic excision biopsy was planned. The surgical exploration revealed the lingual cortex had been destroyed. Further, the gross examination indicated a soft, relatively firm, brownish, gray mass with granular surface measuring approximately 20 mm × 10 mm × 20 mm. Moreover, histopathologic examination showed a normal salivary gland tissue, with many mucous acini and ducts, which was consistent with normal sublingual gland []. The sections from few other areas revealed inflammatory cells, muscle tissue, fat tissue, blood vessels, and nerve bundles []. Thus, based on the clinical, radiographical, and histopathological findings, the final diagnosis of SBC with ectopic salivary gland tissue was made. Clinical and radiographic controls were performed during 3 months of follow-up. No changes in the zone have been detected.