Pediatric Dentistry · patient case question
What is the most appropriate management approach at this stage?
Patient case: Bilateral jaw expansion in a young child
Patient: Male, 6 years old
Chief complaint: "His cheeks have been getting fuller on both sides for about a year. It does not hurt him."
History: Otherwise healthy. No trauma, no fever, no weight loss. The father was told as a child that he had "chubby cheeks" that settled on their own during his teens.
Findings: Painless, firm, bilaterally symmetric expansion of the posterior mandible. Lymph nodes not enlarged. Panoramic and PA radiographs show bilateral, symmetric, expansile multilocular radiolucencies of the mandible with displaced and unerupted teeth.
Show answer and explanation
Correct answer: C. Clinical and radiographic observation, with intervention reserved for functional or severe cosmetic problems
- A. Radiation is contraindicated. Irradiating the jaws of a child with a BENIGN self-limiting condition risks growth arrest and radiation-induced malignancy.
- B. Aggressive resection is not indicated for a condition that regresses on its own, and operating during the active phase is associated with rapid recurrence and needless loss of bone in a growing child.
- C. CORRECT. Cherubism is SELF-LIMITING. Lesions enlarge until puberty, then stabilise and progressively regress with bony infill through the late teens and twenties. Observation is therefore the default. Surgery — usually contouring rather than resection — is deferred until after growth unless the lesions threaten vision, breathing, speech, eruption or produce severe deformity.
- D. Bisphosphonates and other antiresorptives have been reported anecdotally, but there is no established indication for routine use, and antiresorptives in a growing child carry their own risks.
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