Idiopathic bone cavity mimicking a botryoid odontogenic cyst: A rare radiographic presentation in an older adult

Objectives This report describes an unusual case of a multilocular idiopathic bone cavity (IBC) that presented as a botryoid odontogenic cyst situated between the mandibular lateral incisor and canine in an older adult. Background The IBC represents an intraosseous concavity that appears radiographically as a unilocular or multilocular radiolucent lesion found in various skeletal sites, including the jaw. Atypical cases of gnathic IBC have not been appreciated in the gerodontologic literature. Materials and methods The teeth adjacent to the bony lesion had normal pulpal responses to cold. A full‐thickness flap was elevated and provided a direct entry into a bony concavity, which was devoid of an epithelial lining and fluid. Results The lack of a cystic lining within the empty osseous lesion following surgical entry, concomitant with the vital pulpal status of the proximal teeth, led to a diagnosis of an IBC. The bony walls underwent curettage and copious irrigation prior to primary closure. A 10‐month follow‐up revealed partial evidence of osseous repair. The patient will continue to be monitored. Conclusion Timely surgical intervention of central lesions of the jaws may improve clinical outcomes. Variants of the IBC should be included in the differential diagnosis of multilocular lesions, particularly in the geriatric population.