Calcifying Cystic Odontogenic Tumor in Radiologically Normal Dental Follicular Space of Mandibular Third Molars: Report of Two Cases

Two cases of calcifying cystic odontogenic tumor (CCOT) of the dental follicle in an impacted third molar without clinical and radiological evidence are reported during routine histopathological examination. In both the cases left mandibular third molar was mesioangularly impacted with pericoronal radiolucency of less than 2.5 mm, which was not indicative of any pathology. As a routine protocol (which is not practiced widely) of our institution, dental follicles associated with extracted molars were sent for histopathological examination. Histopathological features were consistent with CCOT with pathognomonic ghost cell transformation of odontogenic epithelium. The patients were followed for one year with no recurrence. This paper emphasizes the importance of routine histopathological examination of dental follicles associated with asymptomatic impacted teeth without any clinical or radiographic evidence of follicular lesion.