Calcifying Odontogenic Cyst: A Case Report

Objective To present a rare case of calcifying odontogenic cyst (COC), highlighting its clinical, radiographic, and histopathological characteristics, as well as the challenges in management and follow-up. Case Report A 20-year-old male patient presented with progressive tooth mobility in the mandibular anterior region. Cone beam computed tomography (CBCT) revealed a well-defined, unilocular hypodense lesion with internal calcifications and significant root resorption. A differential diagnosis included COC, adenomatoid odontogenic tumor, and calcifying epithelial odontogenic tumor. Histopathological analysis confirmed COC. Initial decompression was attempted, but due to non-compliance and lesion evolution, complete enucleation was performed. Postoperative follow-up at 6 and 18 months demonstrated significant bone regeneration, no recurrence, and preservation of pulpal vitality. Conclusion This case underscores the importance of a flexible surgical approach tailored to lesion evolution and patient compliance. CBCT played a critical role in diagnosis, treatment planning, and follow-up. Given the absence of standardized imaging protocols for COC, a structured follow-up strategy with CBCT and panoramic radiographs is recommended to monitor healing and detect recurrence.