Nasopalatine duct cysts may present with atypical radiographic features when arising in grafted alveolar cleft regions. A patient with cleft lip and palate presented with a well-defined radiolucent lesion in the anterior maxilla following alveolar bone grafting. Imaging demonstrated a unilocular lesion associated with displacement of the incisive canal, mimicking other odontogenic and nonodontogenic cysts. The unusual location and surgical history posed diagnostic challenges. Local trauma related to grafting may have contributed to cyst development. Careful radiographic assessment is essential for accurate differential diagnosis and appropriate management.
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