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Figure 15c. Images in a 9-year-old girl with a calcifying odontogenic cyst. (a) Panoramic radiograph shows a double cortex (arrowheads) due to cortical expansion, but one cannot determine whether buccal or lingual cortex is involved. Also, the margins of the lesion are poorly defined, the neurovascular bundle is not intensified, and the superimposition of an ectopic tooth (arrow) makes it difficult to determine if resorption of left first bicuspid (b) root has occurred. (b) Panoramic dental CT scan permits better visualization of the lesion (solid arrow), ectopic tooth (open arrow), and mandibular canal (arrowheads). b = first left bicuspid. (c) Cross-sectional dental CT scans clearly demonstrate expansion of the buccal cortex (arrowheads), two unerupted teeth within the lesion (open and thin solid arrows), an erupted left first bicuspid (b), and displacement of mandibular canal (thick solid arrows). (Reprinted, with permission, from reference 7.)