Our appreciation is extended to Dr. Juan Yepes, Indiana University School of Dentistry Department of Pediatric Dentistry and Riley Hospital for Children, for contributing this case.

History: A 9-year-old boy presented to the dentist for a routine dental exam. The patient and his family recently immigrated to the U.S.

The patient was not taking any medications, nor did he have any allergies.

The extraoral exam revealed mild macrocephaly, frontal bossing, and hypertelorism. The dentist ordered a panoramic film. Below is the panoramic x-ray, as well as a cropped image of the right and left side. Click to enlarge the images.