Ameloblastoma and dentigerous cyst associated with impacted mandibular third molar tooth

A healthy 25-year-old man presented with a mass in the right submandibular triangle that had been present for several months. At physical examination, a firm 3-cm mass was noted along the posterior aspect of the right mandibular condyle. Trigeminal and facial nerve functions were intact, and no mucosal lesions were identified. Panoramic radiography and contrast material-enhanced computed tomography (CT) of the facial bones were performed. The patient underwent marginal mandibulectomy and biopsy of the mass, which confirmed the diagnosis of ameloblastoma and dentigerous cyst. Next, segmental mandibulectomy, from the right condyle to the mid portion of the right mandibular body, was performed with curative intent, and the mandible was reconstructed with an osteocutaneous fibular free flap and a reconstruction plate. Subsequent complex closure of the incision with multiple end-to-end vascular anastomoses was required.