A 13 year old girl from Manipur was brought to our hospital by her parents seeking the best treatment for facial asymmetry. The girl initially presented with a complaint of huge swelling in the right side of the face which was increasing in size. The parents were greatly worried about their daughter’s present condition.

Through clinical and radiological investigations revealed a large radiolucent lesion involving the entire ramus and angle of the mandible extending to the lateral side of lower right first molar teeth. Biopsy of the lesion confirmed the lesion to be odontogenic keratocyst. The parents were explained that the facial asymmetry was only due to the cystic contents.

Maxillofacial Surgeon Dr.S.M.Balaji planned to do segmental mandibulectomy followed by reconstruction with rib graft. Dr.S.M.Balaji successfully removed the cyst completely along with the affected bone and teeth. Rib graft was harvested and used to reconstruct the jaw bone defect and the surgical site was closed. After subsequent healing, implants & ceramic crowns will be placed for permanent replacement of lost teeth.