Journal of Dental Medicine

Background and Aims: The incisive canal cyst also known as nasopalatine duct cyst (NPDC) is the most common developmental non odontogenic cyst and it is usually asymptomatic with a well corticated round, ovoid or in some cases unique heart shaped radiolucent radiographic finding. Its accurate diagnosis from odontogenic cysts, odontogenic tumor, and benign non-odontogenic tumors using clinical and radiographic findings leads to eradication of pathologic condition with minimum residual defects and patient discomfort. In this case report, the clinical and radiographic findings of a 60-year-old female with the chief complaint of swelling was reviewed. There were typical histologic and radiographic findings related to nasopalatine duct cyst. The surgical management is explained. Follow up visit showed satisfactory healing and no dehiscence. It could be suggested that heart shaped radiographic finding in 3-D reconstructed image in the maxillary midline would be a good predictor for NPDC.

 This article presents a challenging case of a 64-year-old man with episodic fever, urticarial rash, and arthralgia, prompting a detailed diagnostic process. Despite initial considerations of adult-onset Still's disease, the atypical symptoms led to further investigations, revealing a periapical abscess through a dental examination. The patient's symptoms significantly improved following dental intervention, challenging the initial diagnostic inclination towards a rheumatological disorder. This case underscores the importance of thorough physical examinations and interdisciplinary collaboration in reaching accurate diagnoses. The ultimate diagnosis of systemic presentation due to an occult dental abscess, highlights the need for a comprehensive approach to medical evaluations, considering various clinical aspects and avoiding diagnostics biases. This case study serves as a reminder of the evolving landscape of medical diagnostics and the continued significance of holistic patient assessments and physical examination as valuable practicing skills.