Abstract

With the rise in facial cosmetic procedures, dental practitioners are increasingly encountering incidental ra- diographic findings attributable to dermal fillers. In particular, fillers injected in the anterior mandible may manifest as well-defined radiolucent area on panoramic radiographs, potentially mimicking cystic lesions. This report presents a case in which a radiolucent lesion observed in the mandible on panoramic imaging was ini- tially suspected to be intraosseous. However, cone-beam computed tomography (CBCT) revealed the lesion to be extraosseous in nature, representing labial cortical bone resorption associated with cosmetic filler injection. The initial imaging appearance suggested a pathologic entity, but CBCT was instrumental in clarifying the diagnosis and excluding odontogenic lesion. Filler-induced bone resorption can closely resemble true pathological lesions, posing a risk of misdiagnosis. Comprehensive patient history taking, combined with advanced imaging such as CBCT, is essential for accurate diagnosis. Awareness of filler-related complications helps prevent misdiagnosis. (J Korean Dent Assoc 2025; 63(9): 304-308)