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 66-year-old healthy man was referred from a private dental clinic for evaluation of a multilocular radiolucency at the left molar region of the mandible. Panoramic radiograph revealed a well-defined multilocular radiolucent area under the mandibular canal at the distal root of the second molar tooth (). The lesion showed three lobulated radiolucencies with radiopaque margins in the region of the submandibular gland fossa. On clinical examination, there was no sign of infection, fistula, or nerve damage. No history of expansion on the left mandibular angle area was recorded. The patient had no systemic disease and no specific medical history.\nCBCT scan was recommended for further study. Axial CBCT images showed a lingual bony defect located at the lingual side of the mandibular canal (). Coronal CBCT images showed a lobulated bony defect below the mandibular canal (). The maximum mesiodistal length of the defect was 14.16 mm, and the height was 7.38 mm. The maximum buccolingual length of the defect was 4.44 mm, not showing the expansion or thinning of the buccal cortical bone.\nParasagittal CBCT images showed three lobulated radiolucencies with radiopaque margins between the mandibular canal and the inferior border of the mandible (). Three-dimensional, reformatted CBCT images revealed a bony defect extending from the medial surface of the mandible ().\nThe lesion was diagnosed as a developmental salivary gland defect from the radiographic features. The patient was informed about the lesion and was scheduled for follow-up.