Abstract
BACKGROUND: Stafne bone cavity is a rare, asymptomatic, nonprogressive, developmental pseudocyst typically found incidentally in the posterior mandible. Its occurrence in the anterior mandibular region, especially in the canine-premolar area, is extremely rare and often misdiagnosed as periapical pathology due to its radiographic appearance. This case is unique as it highlights an anterior lingual variant of Stafne bone cavity presenting as a periapical radiolucency, underlining the importance of advanced imaging and clinical correlation in avoiding unnecessary endodontic or surgical interventions. CASE PRESENTATION: A 79-year-old female patient of Indian ethnicity presented for routine dental evaluation. A panoramic radiograph revealed a well-defined, oval radiolucency in the periapical region of mandibular right canine and first premolar (#43, 44). Clinical examination showed vital teeth, absence of symptoms, and no mucosal or bony abnormalities. Cone bean computed tomography revealed a corticated, scooped-out bony defect on the lingual surface of the mandible in the region of the lesion, consistent with anterior variant of Stafne bone cavity. No invasive procedure was warranted, and the patient was placed under periodic follow-up. CONCLUSION: Anterior Stafne bone cavity is a rare entity that can mimic pathological periapical lesions, posing a diagnostic challenge. Radiographic features supported by clinical assessment, including vitality testing and advanced imaging, are essential to avoid misdiagnosis and overtreatment. This case underscores the significance of considering Stafne bone cavity in differential diagnoses of asymptomatic periapical radiolucencies in elderly patients.