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Bilateral Dentigerous Cysts — Report of an Unusual Case and Review of the Literature
Abstract
Dentigerous cysts are the most common developmental cysts of the jaws, most frequently associated with impacted mandibular third molar teeth. Bilateral dentigerous cysts are rare and occur typically in association with a developmental syndrome. The reported occurrence of bilateral dentigerous cysts in the absence of a syndrome is rare and, to date, only 11 cases have been described. Here, we report a case of bilateral nonsyndromic, dentigerous cysts and review the literature for this unusual finding.
... Literatürdeki olgulara göre 3-57 yaşları arasında görülür ve en sık 15 yaşın altında görülür. 9 Dentigeröz kistler, konik ışınlı bilgisayarlı tomografide radyolojik olarak mine-sement sınırından başlayan, gömülü bir dişin kronunu çevreleyen iyi sınırlı, uniloküler, hipodens lezyonlar olarak izlenir. Ayırıcı tanı, odontojenik keratokist ve unikistik ameloblastoma ile yapılmalıdır. ...
... Dentigeröz kistler, düzgün sınırlara sahiptir ve dişlerde rezorpsiyon yapma olasılığı keratokistlerden daha yüksektir. [8][9][10] Dentigeröz kistlerin tek başına görülmeleri yaygın olmasına rağmen sendrom veya sistemik hastalık ile ilişkili olmadan birden çok bölgede görülmeleri oldukça nadirdir. Birden fazla bölgede görüldüklerinde çoğu zaman bilateral olarak görülürler. ...
... Bilateral dentigeröz kistler, sıklıkla Maroteaux-Lamy sendromu ve kleidokraniyal displazi ile ilişkilendiril- miştir. [7][8][9] Olgumuzda da olduğu gibi sendromik olmayan bir hastada 4 kadranda gözlenen dentigeröz kistler, literatürde sadece 5 olguda bildirilmiştir (Tablo 1). Bu olguların çoğunda ön dişlerde görülmüştür. ...
... The literature shows a greater involvement of male gender (63,6%) 17,20-22, 25-27 compared to female patients (36,3%) 18,19,23,24 , with infantile and young adult patients being more affected (81,81%) 17,19,[20][21][22][23][24][25][26] with respect to adult patients (18,18%) 18,27 . The higher incidence in children and young patients seems to be related to the association with unerupted dental elements in the oral cavity. ...
... It is surgeon responsibility to observe by means of imaging examination if the dental follicle is larger when compared to a normal dental follicle, through computed tomography 17,18,20,21,23,26 , panoramic radiography 19,22,24,25,27 , periapical 25 and Waters' projection 27 . In addition, during the surgical procedure of tooth extraction, it is mandatory to observe the thickness of the dental follicle and identify clinical signs suggestive of the presence of cysts. ...
... It is surgeon responsibility to observe by means of imaging examination if the dental follicle is larger when compared to a normal dental follicle, through computed tomography 17,18,20,21,23,26 , panoramic radiography 19,22,24,25,27 , periapical 25 and Waters' projection 27 . In addition, during the surgical procedure of tooth extraction, it is mandatory to observe the thickness of the dental follicle and identify clinical signs suggestive of the presence of cysts. ...
Unilateral dentigerous cyst is a common entity in the oral cavity. Conversely, bilateral dentigerous cysts are rare, especially in non-syndromic patients. The purpose of the present article was to report a case of a bilateral dentigerous cyst in a non-syndromic patient and discuss about the treatment strategy. A literature review was perfomed and only eleven articles was report describing this condition. The orthopantomograph showed impacted wisdom teeth and a bilateral well-defined radiolucent unilocular image around the crown of the lower third molars. The diagnostic hypothesis was bilateral dentigerous cyst. The extraction of the impacted teeth was performed followed by excisional biopsy, which confirmed the diagnosis of dentigerous cyst. It might be concluded that radiographic examination is the first resource to intercept initial changes in the dental follicle through observation of the radiolucent halo. The histopathological examination of the surgical specimen becomes essential to reach a final diagnosis of the lesion.Descriptors: Dentigerous Cyst; Molar, Third; Surgery, Oral.ReferênciasDaley TD, Wysocki GP, Pringle GA. Relative incidence of odontogenic tumors and oral and jaw cysts in a Canadian population. Oral Surg Oral Med Oral Pathol. 1994;77(3):276-80.Zhang LL, Yang R, Zhang L, Li W, MacDonald-Jankowski D, Poh CF. Dentigerous cyst: a retrospective clinicopathological analysis of 2082 dentigerous cysts in British Columbia, Canada. Int J Oral Maxillofac Surg. 2010;39(9):878-82.Farah CS, Savage NW. Pericoronal radiolucencies and the significance of early detection. Aust Dent J. 2002;47(3):262-265.Ricucci D, Mannocci F, Ford TR. A study of periapical lesions correlating the presence of a radiopaque lamina with histological findings. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101(3):389-94.Vencio EF, Mota A, de Melo Pinho C, Dias Filho AA. Odontogenic keratocyst in maxillary sinus with invasive behaviour. J Oral Pathol Med. 2006;35(4):249-51.Al-Khateeb TH, Bataineh AB. Pathology associated with impacted mandibular third molars in a group of Jordanians. J Oral Maxillofac Surg. 2006;64(11):1598-602.Motamedi MH, Talesh KT. Management of extensive dentigerous cysts. Br Dent J. 2005;198(4):203-6.Smith G. Two dentigerous cysts in the mandible of one patient. Case report. Aust Dent J. 1996;41(5):291-93. Fujii R, Kawakami M, Hyomoto M, Ishida J, Kirita T. Panoramic findings for predicting eruption of mandibular premolars associated with dentigerous cyst after marsupialization. J Oral Maxillofac Surg. 2008;66(2):272-76.Motamedi MH, Talesh KT. Management of extensive dentigerous cysts. Br Dent J. 2005;198(4):203-6.Tamgadge A, Tamgadge S, Bhatt D, Bhalerao S, Pereira T, Padhye M. Bilateral dentigerous cyst in a non-syndromic patient: Report of an unusual case with review of the literature. J Oral Maxillofac Pathol. 2011;15(1):91-5.Aher V, Chander PM, Chikkalingaiah RG, Ali FM. Dentigerous cysts in four quadrants: a rare and first reported case. J Surg Tech Case Rep. 2013;5(1):21-6. Pell GJ, Gregory GT. Impacted mandibular third molars: Classification and modified technique for removel. Dent Dig 1933; 39:330-38.Winter GB. Principles of exodontia as applied to the impacted third molar. St Louis: American Medical Books; 1926.Daley TD, Wysocki GP, Pringle GA. Relative incidence of odontogenic tumors and oral and jaw cysts in a Canadian population. Oral Surg Oral Med Oral Pathol. 1994;77(3):276-80.Shafer WG, Hine MK, Levy BM. A Textbook of Oral Pathology. 4th ed. Philadelphia: Saunders; 1983. 258-317 Khandeparker RV, Khandeparker PV, Virginkar A, et al. Bilateral Maxillary Dentigerous Cysts in a Nonsyndromic Child: A Rare Presentation and Review of the Literature. Case Rep Dent 2018; 2018:7583082.Imada TSN, Tieghi Neto V, Bernini GF, Silva Santos PS, Rubira-Bullen IR, Bravo-Calderón D et al. Unusual bilateral dentigerous cysts in a nonsyndromic patient assessed by cone beam computed tomography. Contemp Clin Dent. 2014;5(2):240-42.Sanjay CJ, David CM, Kaul R, Shilpa PS. Kissing dentigerous cysts involving mandibular canines: report of unusual case with review of literature. J Calif Dent Assoc. 2015;43(1):29-33.Byatnal A, Byatnal A, Singh A, Narayanaswamy V, Radhakrishnan R. Bilateral impacted inverted mesiodens associated with dentigerous cyst. J Calif Dent Assoc. 2013;41(10):753-57.Ishihara Y, Kamioka H, Takano-Yamamoto T, Yamashiro T. Patient with nonsyndromic bilateral and multiple impacted teeth and dentigerous cysts. Am J Orthod Dentofacial Orthop. 2012;141(2):228-241.Shirazian S, Agha-Hosseini F. Non-syndromic bilateral dentigerous cysts associated with permanent second premolars. Clin Pract. 2011;1(3):e64.Prasad LK, Chakravarthi PS, Sridhar M, Ramakumar Y, Kattimani V. Nonsyndromic Bilateral Maxillary and Unilateral Mandibular Multiple Dentigerous Cysts in a Young Girl: Report of a Rare Case. Int J Clin Pediatr Dent. 2010;3(3):219-23.Saluja JS, Ramakrishnan MJ, Vinit GB, Jaiswara C. Multiple dentigerous cysts in a nonsyndromic minor patient: Report of an unusual case. Natl J Maxillofac Surg. 2010;1(2):168-72.Cury SEV, Cury MDPN, Cury SEN, Pontes FSC, Pontes HAR, Rodini C et al. Bilateral dentigerous cyst in a nonsyndromic patient: case report and literature review. J Dent Child (Chic). 2009;76(1):92-6.Ustuner E, Fitoz S, Atasoy C, Erden I, Akyar S. Bilateral maxillary dentigerous cysts: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;95(5):632-35.Ko KS, Dover DG, Jordan RC. Bilateral dentigerous cysts--report of an unusual case and review of the literature. J Can Dent Assoc. 1999;65(1):49-51.Chew YS, Aghabeigi B. Spontaneous regression of bilateral dentigerous cysts: a case report. Dent Update. 2008;35(1):63-5.Shah N, Thuau H, Beale I. Spontaneous regression of bilateral dentigerous cysts associated with impacted mandibular third molars. Br Dent J. 2002;192(2):75-6.Aggarwal P, Saxena S. Aggressive growth and neoplastic potential of dentigerous cysts with particular reference to central mucoepidermoid carcinoma. Br J Oral Maxillofac Surg. 2011;49(6):e36-9.Zapała-Pośpiech A, Wyszyńska-Pawelec G, Adamek D, Tomaszewska R, Zaleska M, Zapała J. Malignant transformation in the course of a dentigerous cyst: a problem for a clinician and a pathologist. Considerations based on a case report. Pol J Pathol. 2013;64(1):64-8.Spoorthi BR, Rao RS, Rajashekaraiah PB, Patil S, Venktesaiah SS, Purushothama P. Predominantly cystic central mucoepidermoid carcinoma developing from a previously diagnosed dentigerous cyst: case report and review of the literature. Clin Pract. 2013;3(2):e19.Bereket C, Bekçioğlu B, Koyuncu M, Şener İ, Kandemir B, Türer A. Intraosseous carcinoma arising from an odontogenic cyst: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013;116(6):e445-49.
... DCs are very common benign developmental cysts which generally involve impacted, unerupted permanent teeth, supernumerary teeth, odontomas, and, rarely, primary teeth [1]. They usually occur singly and are located in the mandible. ...
... They usually occur singly and are located in the mandible. DCs comprise the second most common type of odontogenic cysts, representing nearly 24% of all the true jaw cysts [1][2][3][4]. The World Health Organization classification of jaw cysts refers to the DCs as an epithelial developmental odontogenic cysts [5]. ...
... The World Health Organization classification of jaw cysts refers to the DCs as an epithelial developmental odontogenic cysts [5]. They are attached to or enclose the crown of the unerupted tooth at the cemento-enamel junction (CEJ) [1]. Though DCs may be seen in patients across a wide age range, they are most frequently discovered in patients between 10 and 30 years of age. ...
Dentigerous cysts (DCs) known as follicular cysts are thought to be caused by a developmental abnormality derived from the reduced enamel epithelium (REE) of the tooth forming organ. DCs considered an epithelial lined developmental odontogenic cyst which usually occurs in the second and third decade of life. DCs are the second most prevalent cystic lesions of the jaw following the radicular cyst. They are associated with partially erupted, developing, supernumerary or impacted teeth. Locations wise in the jaw, the mandibular third molars followed by maxillary canines are preferred sites. Occurrence of DCs is commonly unilateral. Bilateral presence is generally observed in syndromic cases. Non-syndromic DCs occurring bilaterally or involving both arches at the same time is very rare.
... Dentigerous cysts are the second-most-common odontogenic cysts noted in the jaws after radicular cysts. 1 Dentigerous cyst, also referred to as follicular cyst arises as a result of fluid accumulation between the enamel surface of a tooth and reduced enamel epithelium overlying it, resulting in a cyst in which the tooth crown is encompassed within the lumen. 2 Majority of these cysts are asymptomatic and hence, they are frequently noted during routine radiographic examination. 3,4 Statistics reveal a greater incidence in young men with a ratio of 1.6:1. ...
... Although it may involve any tooth, the mandibular third molars are the most commonly affected teeth. 1 Other frequently involved teeth are the permanent maxillary canines and mandibular premolars. Rarely, it is associated with multiple impacted teeth, odontome, deciduous teeth and supernumerary teeth. ...
... Typically, dentigerous cysts are asymptomatic, only causing discomfort if a secondary infection occurs. 3 These cysts predominantly appear in individuals during their 2 nd or 3 rd decades of life, and their occurrence in childhood is quite rare. The lower third molars and maxillary canines are the mostly affected teeth. ...
... Dentigerous cysts are typically solitary lesions, although bilateral and multiple cysts have been reported in patients with specific syndromes, such as basal cell nevus syndrome, mucopolysaccharidosis, and cleidocranial dysplasia. 3,4,7 Bilateral mandibular dentigerous cysts have been linked to long-term use of cyclosporine A combined with calcium channel blockers. These cysts are extremely rare without underlying syndromes or systemic diseases. ...
... Comparatively, males are twice as affected as females [3]. While any tooth may be impacted by the cyst, mandibular third molars are the most frequently afflicted [4]. Large dentigerous cysts may be linked to the painless extension of the jaw in the affected area. ...
... Often, dentigerous cysts are found during radiographs ordered to look into dental malalignment, tooth loss, or failed tooth eruption. The cyst often doesn't cause any pain or discomfort unless it develops a secondary infection [4]. ...
One of the most prevalent types of odontogenic cysts is a dentigerous cyst, which is usually connected to the crown of an immature tooth. We report the case of an 11-year-old boy, who had a swelling over his left cheek, which was determined to be a dentigerous cyst by radiological imaging and clinical examination. Over the course of two months, the peanut-sized mass grew to 3x2 cm. A massive, well-defined cystic lesion connected to an unerupted premolar tooth was found on a CT scan of the left maxillary alveolar arch and sinus floor. Under general anesthesia, the patient had a Caldwell-Luc surgery to remove the cyst. In order to avoid difficulties related to cyst formation, which can invade surrounding tissues and even result in cancer if left untreated, early detection using radiological imaging is essential. Complete excision of the cyst is the treatment, particularly for big lesions, in order to limit morbidity and lower the likelihood of aggressive behavior. This case emphasizes the necessity of thorough examination and surgical intervention when necessary, underscoring the significance of early identification and adequate therapy to minimize potential problems related to dentigerous cysts. In cases of dentigerous cysts, early intervention, and appropriate surgical procedures are critical to reducing morbidity and improving patient outcomes.
... Usualmente são assintomáticos, sendo descobertos apenas em exames radiográficos para áreas correlatas. Os cistos podem aumentar consideravelmente de tamanho, podendo os maiores estarem associados à expansão indolor do osso na região afetada e provocar uma assimetria facial (KO et al.,1999). ...
... Na literatura é possível observar relatos de caso sobre cistos dentígeros em pessoas com 5 a 57 anos de idade, mas acometendo principalmente pessoas do sexo masculino entre a primeira e terceira década de vida (KO et al., 1999). Cistos odontogênicos geralmente são imperceptíveis e só são observados após a realização de radiografias para outra patologia ou quando a inflamação aguda se desenvolve (PASQUALE, 1994). ...
O cisto dentígero é o segundo tipo mais comum dos cistos odontogênicos do complexo maxilofacial, perdendo apenas para o radicular. Este trabalho tem por objetivo realizar uma breve revisão de literatura sobre os conceitos e reportar o caso de um paciente do gênero masculino, 21 anos de idade, ressaltando suas principais características etiológicas, clínicas, radiográficas, histopatológicas e formas de tratamento. Conclui-se que a abordagem cirúrgica escolhida foi a melhor opção considerando fatores locais e a boa resposta tardia quanto ao reparo. As considerações abordadas visam auxiliar os profissionais de odontologia na resolução dessa patologia e com isso concluir qual o melhor tratamento e tentar diferenciar o cisto dentígero de outras imagens radiográficas semelhantes.
... The first theory suggests that fluid accumulation between the reduced enamel epithelium and the crown of the permanent tooth germ results from the pressure exerted by the erupting tooth on its own dental follicle, which would cause the exit of serum exudates from capillaries because of obstruction of venous return. 14,15 The second theory advocates that, along its eruption path, the immature permanent tooth encounters a radicular cyst originating from its primary predecessor. This is the least accepted hypothesis because radicular cysts rarely develop associated with primary teeth. ...
... [5][6][7][8] Bloch in his hypothesis suggested that the resultant periapical inflammation from an overlying necrotic deciduous predecessor will spread to involve the follicle of unerupted permanent successor resulting in accumulation of inflammatory exudates, thus leading to dentigerous cyst formation. 8,15,18 Toller stated breakdown of proliferating cells of follicle after impeded eruption. The eruption of a tooth associated with a dentigerous cyst seems to be more influenced by its angulations and position inside the alveolar bone than by the cyst dimensions and amount of available space within the dental arch. ...
... Dentigerous cysts are the second most frequent odontogenic cysts after root cysts, constituting approximately twenty-four percent of all mandibular cysts [9]. The cyst is formed from the separation of the crown follicle from a non-erupted tooth, and although it may involve a tooth, the lower third molars are the most affected [12]. The incidence by age groups has been different according to the data of various authors, but its occurrence is more frequent in men than in women [13]. ...
... Often they are casual findings, clinically the dentigerous cyst is asymptomatic (except in case of secondary infection), but can cause bone cortical expansion and consequently local deformity in some cases [12]. ...
... Their frequency in general population has been estimated at 1.44 cyst for every 100 unerupted teeth (Mourshed, 1964). Although dentigerous cysts are highly prevalent, bilateral occurrence is rare and usually associated with syndromes or systemic diseases (Freitas et al., 2006), such as Maroteaux-Lamy syndrome (Ko, 1999), cleidocranial dysplasia and mucopolysaccharidosis. In absence of these syndromes bilateral dentigerous cyst are rare. ...
... Since the cyst can attain large size with minimum or no symptoms, early detection and removal of cyst is important to reduce morbidity. It is therefore important to perform radiographic examination of unerupted teeth (Ko, 1999). An orthopantomogram gives a better view of all the erupted and unerupted teeth with their associated lesions 5 . ...
Dentigerous cysts are the most common developmental cysts of the jaw, most frequently associated with impacted mandibular third molar teeth. Bilateral dentigerous cysts are rare and occur typically in association with a developmental syndrome. The reported occurrence of bilateral dentigerous cyst in the absence of a syndrome is rare. Here we repot a case of bilateral nonsyndromic, dentigerous cyst in mandible of non-syndromic 15year old female patient. Copyright©2017, Shruthi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
... [3] They are attached to or completely encircle the crown of the uneruptied tooth. [4] Majority of dentigerous cysts have impacted permanent teeth. Dentigerous cysts have, however also been shown to occasionally have impacted primary teeth. ...
Dentigerous cysts comprise the second most common type of odontogenic cysts, after radicular cysts, representing nearly 20% of all the true jaw cysts. A vast majority of the dentigerous cysts are associated with impacted permanent teeth. We report a case of full term one day old male neonate, presented with an intraoral mass in the anterior sector of the mandible suggestive of Dentigerous cysts. Our case, which is a rare presentation of dentigerous cyst in a 1 day old neonate—the earliest case to be documented—points to the fact that the cyst may be manifested even before the eruption of the first permanent tooth, and can be actually associated with it.
... DC is suspected if size of the follicular space measured on the radiograph is more than 5 mm. [8] . In our case, OPG revealed a well -defined show radiolucent lesion associated with deciduous canine, molars and permanent canine and premolars. ...
The dentigerous cysts are odontogenic cysts associated with impacted or unerupted teeth and supernumerary teeth. This is a case report of a large dentigerous cyst encroaching maxillary sinus in a11-year-old female patient where the surgical enucleation was done.
... Previous reports and reviews on bilateral dentigerous cysts in nonsyndromic patients have identifi ed 22 cases in the English-language literature (TABLE). 7,15 The age range for the reported cases varies widely from 5 to 57 years of age. Of the reported cases, 13 cysts were reported in children younger than age 12, as compared to our case, which is the fi rst to be diagnosed in third decade of life. ...
Dentigerous cysts are odontogenic developmental cysts, which mostly surround the crown of unerupted teeth, odontomas or supernumerary teeth. These cysts are mostly solitary in occurrence and their bilateral presentation is rare, especially in the absence of syndromes such as Maroteaux-Lamy, basal cell nevus or cleidocranial dysplasia. We present an unusual case of a 24-year-old female with nonsyndromic bilateral dentigerous cysts associated with unerupted mandibular canines that were diagnosed histopathologically as dentigerous cysts.
... Frequency of dentigerous cyst formation has been calculated as 1.44 in every 100 unerupted teeth. [1][2][3] Dentigerous cyst is defined as cyst that originates by separation of follicle from around crown of unerupted tooth. 4 They are generally associated with crowns of impacted or unerupted permanent teeth, but they can be associated with an odontoma or developing tooth, and even deciduous teeth. ...
Cysts of jaw present as swellings of jaws and midface. Of different varieties, dentigerous cyst is most common type of noninflammatory odontogenic cyst. Dentigerous cysts are generally associated with crowns of impacted or unerupted permanent teeth. Here we present a case of dentigerous cyst in 13‑year‑old female child, which was successfully treated with conservative therapy. Patient also reported after one and half year with protruding teeth and retained deciduous right upper canine & impacted permanent canine. This case report also presents orthodontic management of retained deciduous canine and impacted permanent canine.
... Surgical treatment of dentigerous cyst usually includes marsupialization and enucleation along with or without the extraction of the impacted tooth. Enucleation of the lesion along with or without removal of associated [2,6,7,16,17] is done when the cyst is small, no vital adjacent structures, tooth, not in a favorable position, need accelerated healing, and no recurrence. Enucleation with alter the normal tooth development and in certain circumstances especially in children, the involved tooth should be given a chance to erupt and large cyst if enucleated result in pathological fractures and damage to the viral structures and tooth buds also. ...
... İnflamasyonun olduğu durumlarda ise epitelyal hiperplazi oluşumu gözlenebilir. 17 Ayırıcı Tanı: Özellikle küçük boyuttaki dentigeröz kistler hiperplastik folikül ile karıştırılabilir. Normal folikül genişliği yaklaşık 2-3 mm'dir. ...
... [1] As the tooth erupts, the follicle it is pressing on blocks the flow of blood to the capillary wall, which results in fast serum transfusion across the capillary walls. [2,3] The proliferative cell death of the follicle after a delayed eruption, according to Toller, [4] is at the probable genesis of the dentigerous cyst. As a result of these breakdown products, the osmotic pressure rises, resulting in cyst development. ...
The most frequent odontogenic developing cyst linked with an impacted tooth is the dentigerous cyst. They are normally asymptomatic and are identified during routine radiography tests to see if a tooth is missing from the arch. This case report is designed to demonstrate how an enucleated dentigerous cyst with impacted teeth led to the spontaneous recovery of a bone defect without the need for bone graft. The radiographic scan (OPG) 6 months after cystectomy revealed the creation of adequate bone for the insertion of the implants. As a result of this procedure, the patient's functional, physiologic, and psychological demands were addressed, and the cyst recurrence was avoided. Dental implants were the greatest choice for tooth replacement if significant bone regeneration could be achieved.
... An average follicular space is between 3 and 4 mm, when it exceeds 5 mm, a dentigerous cyst is anticipated. Dentigerous cysts can grow to a considerable size and an extensive lesion can cause facial asymmetry [5]. A multitude of parameters influences the selection of the surgical approach, which includes the size of the cyst, the extent of its invasion to the adjacent structures, the age of the patient, and the functional and cosmetic significance of the involved impacted tooth. ...
Dentigerous cysts are benign, slow-growing odontogenic cysts that are considered to be developmental in origin. They are twice as common in men than in women, and most often occur in people between the ages of 20 and 40 years. They are rarely found in young children. They almost exclusively occur in permanent dentition and over 70% of total number of cases are located in the mandible. Dentigerous cysts most commonly involve the mandibular third molar and are infrequent in maxillary canines. They can grow to a considerable size causing painless expansion of the jaw leading to its deformity.
We report a rare and challenging case of ectopically erupted massive dentigerous cyst of maxillary canine in the anterolateral wall of left maxilla leading to facial deformity and shed a light on its surgical management by the endonasal endoscopic approach in a female pediatric patient.
... The differential diagnosis of this inherited disorder includes mucolipidosis, an inherited metabolic disorder that affect the normal turnover of glycosaminoglycans and lipids in the body, and GM1 gangliosidosis, an inherited disorder that progressively destroys nerve cells (neurons) in the brain and spinal cord. These disorders can be ruled out with genetic testing of the patient [16,17]. ...
Mucopolysaccharidosis VI is a genetic disorder affecting multiple organs with sundry clinical presentations. The main etiological factor reflects the disturbances in mucopolysaccharide metabolism leading to deposition of acid mucopolysaccharide in various tissues. The pathognomonic features of the disease include a large head, short neck, corneal opacity, open mouth associated with an enlarged tongue, enlargement of the skull, and long anteroposterior dimension with unerupted dentition, dentigerous cyst-like follicles, condylar defects, and gingival hyperplasia. An 18-year-old boy with Maroteaux-Lamy syndrome (mucopolysaccharidosis type VI) is described in this article, emphasizing the oral manifestations and radiographic illustration of lesions in the jaws. It also emphasizes the essential role of cone-beam computed tomography to identify and analyze multicentric pathologies in the jaws.
... DC arises from an extraordinary expansion of the dental follicle of an unerupted tooth. DC can be suspected if the follicular space on the radiograph is more than 5 mm [8]. In our case, panoramic radiographs clearly show radiolucent lesion associated with one premolar and deciduous carious molar. ...
A dentigerous cyst is an odontogenic cyst thought to be of developmental origin associated with the crown of an unerupted tooth. Such cysts remain initially completely asymptomatic unless when infected. It is detected clinically when becomes large and associated with swelling of the face. The purpose of this case report was to describe the diagnosis and management of a dentigerous cyst in an 8-year-old boy. The chosen treatment was cyst enucleation and tooth extraction.
... Odontogenic cysts are the most common form of cystic lesions that appear in the maxillofacial region because of the large amount of odontogenic epithelial residue remaining in the tissue. The epithelium in the formation of cysts in the jaw originates from the remaining tissue of the dental lamina and the remaining cells from Serres (cell rests of Serres) and the shrinkage of the enamel epithelium that makes up the dentin follicles due to the growth of teeth and the remaining cells from Malassez (cell rests of Malassez) [2,3]. Dentigerus cyst, also known as follicular cyst, is a cyst that covers part or all of a tooth crown that does not grow and is attached to the tooth root (amelocemental junction). ...
Introduction: Dentigerous cyst is a pathological epithelial cavity that surrounds an unerupted tooth crown. Dentigerous cysts are usually associated with impacted teeth, mandibular third molars, first and second premolars and canines. Dentigerous cysts can occur at any age, but most cases of these cysts occur at the age of approximately 20 years. Men are affected more often than women. Purpose.To find out how the mechanism of dentigerous cysts. The cyst cavity is lined with epithelial cells derived from the epithelial enamel that is reduced from the tooth-forming organs. According to its pathogenesis, the pressure exerted by an erupted tooth on the follicle can block venous flow leading to accumulation of exudate between the reduced enamel epithelium and the crown of the tooth. These cysts are mostly due to fluid accumulation either between the reduced enamel epithelium and the enamel or between the layers of the enamel organ. This fluid accumulation occurs as a result of the pressure exerted by the erupting tooth on the affected follicle, which blocks venous flow, thus inducing rapid transudation of serum in the capillary walls. Discussion: The expansion of the dentigerous cyst causes the release of bone resorbing factor and an increase in the osmolarity of the cyst fluid as a result of the discharge of inflammatory cells, the discharge of residual epithelial enamel and tooth enamel, and desquamation of epithelial cells into the lumen of the cyst. In theory, the fluid will cause cystic proliferation. because the hyperosmolar content produced by cellular breakdown and cell products causes an osmotic gradient to pump fluid into the lumen of the cyst or it can also be said that an increase in the osmolarity of cyst fluid is the result of a shortcut to inflammatory cells and desquamation of epithelial cells into the lumen of the cyst resulting in a dentigerous cyst. Conclusion: The dentigerous cysts that surround the unerupted dental crowns are caused by the accumulation of fluid either between the reduced enamel epithelium or between the layers of the enamel organs. Dentigerous cysts can cause infection, pain, swelling, root dislocation, and resorption of adjacent tooth roots.
... The dentigerous cyst is the second most common type of odontogenic cysts following the radicular cyst and represent approximately 20-24% among all jaw odontogenic cysts [1][2][3] . By definition, a dentigerous cyst develops around the crown of an unerupted tooth and is attached to the tooth cervix (enamel-cementum junction). ...
... 95% CI=18.8-56.7). In contrast, the highest OPG<RANKL ratio was found in Although it is asymptomatic and rarely aggressive, in some cases it may cause significant bone expansion and teeth dislocation (27). On the other hand, the ameloblastoma and the odontogenic keratocyst present a more invasive biological behavior with a potential destructive growth (28). ...
The aim of this study was to assess and compare RANK, RANKL, and OPG immunoexpression in dentigerous cyst, odontogenic keratocyst, and ameloblastoma. The protocol was registered in PROSPERO (CRD42018105543). Seven databases (Embase, Lilacs, LIVIVO, PubMed, Scopus, SciELO, and Web of Science) were the primary search sources and two databases (Open Grey and Open Thesis) partially captured the “grey literature”. Only cross sectional studies were included. The JBI Checklist assessed the risk of bias. A meta-analysis with random effects model estimated the values from the OPG and RANKL ratio reported by the individual studies and respective 95% confidence intervals. The heterogeneity among studies was assessed with I2 statistics. Only nine studies met the inclusion criteria and were considered in the analyses. The studies were published from 2008 to 2018. Two studies presented low risk of bias, while seven studies presented moderate risk. The meta-analysis showed the highest OPG>RANKL ratio for dentigerous cyst (ES=43.3%; 95% CI=14.3-74.8) and odontogenic keratocyst (ES=36.8%; 95% CI=18.8-56.7). In contrast, the highest OPG<RANKL ratio was found for ameloblastoma (ES=73.4%; 95% CI=55.4-88.4) and it was higher in the stromal region compared to the odontogenic epithelial region. The results may explain the aggressive potential of ameloblastoma from the higher OPG<RANKL ratio in this tumor, while it was lower for dentigerous cyst and odontogenic keratocyst.
... 8 Most of the cases reported in literature have reported only a unilateral incidence of Dentigerous cysts and the possibility of the occurrence of multiple dentigerous cysts is very rare and almost exclusively in relation with syndromes or systemic pathologies involving metabolic or developmental disturbances such as mucopolysaccharidosis and cleidocranial dysplasia. 16,13 In a review of literature from 1943 to 2016 as minimal as 32 cases have been reported of multiple dentigerous cysts without any underlying syndromes with 24 cases occurring only in the mandible, 3 cases only in the maxilla while 3 cases were reported with multiple cysts in the maxilla and mandible. 14 The histiogenesis of dentigerous cysts has been a topic of debate amongst researchers for quite a while now and different theories have been postulated regarding the same based on the multitude of observations of different studies. 2 The most common and widely approved theory is that dentigerous cysts develop as a result of fluid accumulation around the crown of the unerupted tooth within the follicle surrounding it. ...
Dentigerous cysts have been reported to make up around 24% of all the cysts occurring in the oral cavity.
Frequently associated with unerupted tooth follicles, the exact histiogenesis and origins of cysts still remains a
topic of research. This cyst is known to occur mainly in the second to third decade of life with a predilection for
males. The occurrence of Dentigerous cysts in association with premolars is believed to be less than 2.4%. In
the maxilla Dentigerous cysts are noted to occur more commonly in association with unerupted or impacted
canines. The following article attempts to review some key facts pertaining to the literature of this cyst and
report a case of Maxillary Dentigerous cyst associated with a maxillary premolar.
... Není tedy zánětlivého původu, ale je cystou vývojovou [20]. Nejčastěji jsou tímto procesem postiženy třetí moláry dolní čelisti [4]. Svým chováním je specifická odontogenní keratocysta, která se, jak je již výše uvedeno, zakládá ze zbytků dentální lišty [6]. ...
... 3 However, they can grow considerably and cause expansion of the cortical bone, facial deformation, paraesthesia and discomfort. 11 They may be associated with some syndromes, when they present in multiple or bilateral forms, such as Maroteaux-Lamy and Cleidocranial Dysplasia. 11 ...
Purpose: The dentigerous cyst is the second most common odontogenic cyst in the jaws. These lesions are observed in routine examinations. The third molars and maxillary canines are the most affected teeth. Definition of marsupialization and enucleation techniques as well as consideration of important objective criteria for the treatment plan like cyst size, age, and proximity to anatomical structures, clinical importance of the tooth or teeth associated with the lesion and risk of bone fracture. This paper will present a case report treated by maneuver of decompression followed by enucleation and bone reconstruction. Case report: A 43-year-old female patient, Caucasian, attended the Oral-Maxillofacial Surgery consultation at Clitrofa - Centro Médico, Dentário e Cirúrgico, in Trofa - Portugal, to assess extraction of 3.8 and 4.8. On intraoral physical examination, a slight bulging of the cortical bone was noted in the region of the left external oblique line. Aspiration puncture was performed and a small amount of light-yellow liquid confirmed the cystic nature of the lesion. In a second stage, osteotomy through piezoelectric surgery was performed. The cystic capsule was excised together with the extraction of tooth 3.8 included and tooth 3.7. Bone regeneration was performed. The material obtained from the cystic cavity was sent for pathological examination, confirming the diagnosis of dentigerous cyst. During observation of the patient for twelve months, no hypoesthesia or any sign of recurrence of the lesion was observed. Conclusion: The technique preserved the neurosensory function and was effective for the enucleation and reconstruction of the lesion. Despite the clinical peculiarities of each case and the chosen treatment method, the prognosis of these lesions is favourable when appropriate therapy is used.
... One such mechanical obstruction is the formation of a DC associated with an unerupted tooth. Dentigerous cyst is the most frequently occurring type of developmental cysts in the jaw, accounting for 24% of cases [3]. It has a male predilection and typically occurs in the second and third decades of life [4][5][6]. ...
Introduction: There are many possible causes for delayed tooth eruption. A dental professional needs to recognize when to investigate further and/or refer for specialist assessment, since early diagnosis and intervention will improve patient outcomes. In the current litigious climate, dental professionals must also be vigilant to avoid claims of clinical negligence. Case Report: The case presented is that of a 19-year-old male with dentigerous cysts (DCs) associated with all four unerupted third molars. The mandibular cysts also involved the second molars, in which failure of eruption was not investigated at a younger age. This delay is likely to have led to the need for more extensive surgery which carried a greater risk of complications. Conclusion: It is important for a dental professional in primary care to recognize delayed eruption and investigate further with appropriate radiographs. Prompt referral for specialist opinion, as with any clinical anomaly, improves patient outcomes and reduces the risk of litigation.
... Dentigerous cysts are associated with the buds of permanent teeth. This is the second most common group of jawbone cysts, after root cysts [6,17,18]. Dentigerous cysts occur more frequently in the mandible than in the maxilla and are usually associated with wisdom teeth [18]. They are divided into three main categories: ...
Supernumerary teeth as mesiodentes in adults are a rare condition. Given that mesiodentes often interfere with the eruption of normal permanent incisors, the majority are diagnosed in teenagers. In some cases, this pathology is associated with the presence of a dentigerous cyst. Imaging techniques play a significant role in the diagnosis of cysts, particularly cone beam computed tomography (CBCT). Once the correct diagnosis is established, appropriate therapeutic measures – usually surgical – should be initiated promptly.
The case presented here is that of a 55-year-old male with an extensive dentigerous cyst arising from a maxillary mesiodens. The decision was made to perform enucleation of the cyst along with the mesiodens inside it. The procedure was performed under general anesthesia. No complications were observed in the postoperative period. The histopathology report confirmed a dentigerous cyst. Radiograph images obtained 10 months post-surgery showed spontaneous bone tissue reconstruction.
... However, complications from dentigerous cysts include secondary infection, which causes them to enlarge and become painful [6]. Radiographically, dentigerous cysts appear as well-defined, radiolucent lesions with sclerotic borders associated with an unerupted tooth and surrounded by a cystic space exceeding 5 mm 3 [7]. ...
Patient: Male, 44
Final Diagnosis: Bilateral dentigerous cyst
Symptoms: Retained anterior deciduous tooth
Medication: —
Clinical Procedure: Bilateral cyst enucleation
Specialty: Dentistry
Objective
Unknown ethiology
Background
Dentigerous cysts are slow-growing odontogenic cysts that usually develop unilaterally as part of a pre-existing syndrome. Non-syndromic bilateral dentigerous cysts are extremely rare, but clinicians should be aware of this condition to ensure prompt diagnosis and management and to prevent complications.
Case Report
A case is presented of bilateral mandibular dentigerous cysts that were discovered incidentally in a 44-year-old man who presented for extraction of a retained maxillary deciduous tooth. Histological examination of the tissue specimens following bilateral enucleation confirmed the diagnosis of bilateral dentigerous cysts.
Conclusions
In this case, incidental bilateral dentigerous cysts were identified and treated by enucleation. The absence of an associated syndrome should not exclude the possibility of the diagnosis of dentigerous cysts, which should be removed to prevent future complications.
... The development of dentigerous cyst is due to fluid accumulation between the epithelium and the crown of an unerupted tooth. 2,3,12 Dentigerous cysts occur in an assorted range of age group with a peak frequency of 2 nd to 4 th decades of life and in the current case it occurred in the 3 rd decade. 5 Generally mandibular third molars are the most frequently affected, which was seen in our case, followed by the maxillary canine, mandibular second premolar and maxillary third molar. ...
In the jaws, the most common type of developmental odontogenic cyst is dentigerous cyst, mostly affecting the impacted mandibular third molars and permanent maxillary canines. They are often noted as an incidental finding on radiographs as unilocular radiolucency with well-defined sclerotic border which encircles the crown of an unerupted tooth as most of these dentigerous cysts are clinically asymptomatic. Long standing cases of dentigerous cysts can progress to either ameloblastoma or squamous cell carcinoma or mucoepidermoid carcinoma. Henceforth, an early clinical and radiographic detection of the cyst plays a vital role so that apt treatment modalities can be carried out which will prevent or decrease the morbidity. With this above background, we hereby report an enticing case of dentigerous cyst which was incidentally observed in conventional radiographs and to evaluate further extension and nature of lesion, a conebeam computed tomography (CBCT) of jaw was taken.
... If a follicular space on radiography is more than 5 mm, an odontogenic cyst can be suspected [14]. Other odontogenic cysts like radicular cysts, odontogenic keratocysts, and odontogenic tumors such as ameloblastoma, Pindborg tumor, odon-toma, odontogenic fibroma, and cemetomas may share the same radiologic features as dentigerous cysts [15,16]. ...
Introduction
Dentigerous cysts are the second most common form of benign odontogenic cysts. These cysts are commonly single lesions. Bilateral and multiple dentigerous cysts are very rare.
Case presentation
This article presents a rare case report of bilateral dentigerous cysts associated with two ectopic teeth located atypically in the maxillary sinuses in a 19-year-old male manifesting as bilateral upper jaw pain, post-nasal discharge and recurrent sinusitis which was managed via the endonasal endoscopic approach by enucleation of the cysts and teeth removal.
Conclusion
This paper presented our experience in the management of a rare case of bilateral dentigerous cysts associated with ectopic teeth in the maxillary sinuses. Ct scan of the paranasal sinuses confirmed the diagnosis and the endonasal endoscopic approach is superior to the external approaches in preserving physiological function in managing these patients.
... The presence of multiple maxillary cysts is not associated with syndromic disease such as mucopolysaccharidosis, basal cell nevus syndrome or Moroteaux-Laury syndrome is an extremely rare condition. 4,5,19 Dentigerous cysts represent 25% of all cysts of the maxilla, second in order of frequency immediately after the radicular cysts. 28 They are localized in the mandible in 75% 1 of cases and the most involved dental elements are the lower third molar and the superior canine. ...
Aim: The aim of the article is to describe an unusual case of a non-syndromic patient affected by three follicular cysts in the mandible and then by an inflammatory cyst. Furthermore, we describe two different surgical approaches that we have used to manage this case: marsupialization and enucleation. Background: Dentigerous cysts are usually solitary cyst, the presence of multiple cysts is often combined with systemic diseases such as mucopolysaccharidosis, cleidocranial dysplasia, and basal cell nevus syndrome. They are the second cysts in order of frequency. Because of the lack of symptoms, their diagnosis is frequently radiological, and it can be suspected by the failure of tooth eruption. Case description: Two bilateral cysts of the third lower molars and radicular cyst of the right second lower molar were treated. An excisional therapy for the two dentigerous neoformations was performed. While, as a function of the remarkable dimensions which characterized the lesion, a conservative approach by marsupialization for 8 months before, and excision after, were chosen to solve the radicular inflammatory cyst. To preserve the patency of the cystic cavity, an acrylic obturator was used. Conclusion: In the case of multiple dentigerous cysts, a deepen clinical and systematic examination should be done to rule out any associated syndrome. Nowadays in literature, there is not a single and significant orientation based on the results obtained from the various techniques, but this case report shows that it is possible to achieve the expected therapeutic success even if in the same patient. Clinical significance: The case that we have described allows us to observe how a correct study of the lesions allows us to have a more accurate, safe and predictable therapeutic approach that lasts in time. © 2018, Jaypee Brothers Medical Publishers (P) Ltd. All rights reserved.
... Myers et al. [6] Some authors report that surgery is not the best treatment for dentigerous cysts. Two rare cases of bilateral dentigerous cysts were reported, in which the cysts underwent spontaneous regression without surgical intervention [7,10]. ...
A dentigerous cyst is an odontogenic cyst, associated with the crown of an impacted or unerupted tooth. The occurrence of bilateral dentigerous cysts is uncommon among the odontogenic cysts of the jaw, as they are usually solitary. Multiple cysts, when reported, are generally associated with syndromes such as cleidocranial dysplasia, Maroteaux-Lamy syndrome, and systemic diseases like mucopolysaccharidosis. This article presents a case of bilateral mandibular dentigerous cysts in a nonsyndromic patient, along with a review of the literature and an examination of the treatment modality.
A dentigerous cyst is a developmental odontogenic cyst frequently associated with lower third molars, upper canines, and lower second premolars. In most cases, dentigerous cysts are present asymptomatically. The growth is gradual and when it reaches a significant size, it may affect anatomical structures and adjacent teeth. The majority of these cysts are detected during regular radiographic examination. They are induced by the degeneration of the enamel organ’s stellate reticulum, which results in fluid accumulation between the crown and the reduced enamel epithelium. In the presented case, we report the progression of a dentigerous cyst associated with an impacted left mandibular third molar. The cyst behavior, differential diagnosis, and management are discussed.
Dentigerous cyst is a developmental odontogenic cyst that often develops in the second and third decades of life. This is one of the most common odontogenic cyst types that involve developing, or impacted teeth, partially erupted, accounting 20% of all jaw cysts. Dentigerous cysts are usually unilateral, bilateral presentations have been associated with syndromes such as cleidocranial dysplasia and Maroteaux–Lamy syndrome. However, they can occur without any syndrome association, but are extremely rare. This article reports the case of bilateral dentigerous cysts that is non-syndromic in a 9-year-old boy.
Cistos dentígeros são o segundo cisto odontogênico mais frequente nos maxilares, é uma lesão benigna derivada do epitélio odontogênico da parte coronária, associadas aos elementos dentários impactados ou inclusos. São observados em exames de rotina ou quando não há a erupção de um dente permanente. O seu crescimento é lento e assintomático. Ocorre principalmente nas três primeiras décadas de vida, com predileção em pacientes do sexo masculino e predominância em leucodermas. O objetivo deste trabalho é relatar o caso de uma paciente com noves anos, que apresentou um cisto dentígero sintomático na região de corpo mandibular esquerda. A abordagem cirúrgica foi realizada em ambiente hospitalar sob anestesia geral, com a enucleação da lesão e conservação do elemento dentário associado. Após 19 meses de proservação, foi notado que o segundo molar inferior manteve seu processo de rizogênese natural, a área manuseada apresenta sinais clínicos de coloração normal, ausência de edema e a paciente encontra-se sem sinais de recidiva e ausência de sintomas subjetivos.
Introduction: Dentigerous cyst is an odontogenic cyst. It is caused by accumulation of fluid between the epithelium of the crown and the crown of an unerupted tooth. It is attached to the neck of the tooth and its size increases by the expansion of the follicle. This cyst most commonly affects the impacted 3rd molar and maxillary canine. Case Report: In the present paper, we report a case of dentigerous cyst associated with impacted canine in a 13year aged female. Conclusion: The patient was treated surgically by enucleation of the cyst.
O miofibroma é uma lesão benigna raramente encontrada na cavidade oral que afeta na maioria das vezes crianças e adolescentes, porém também pode ser encontrado em adultos, acometendo a região mandibular. O diagnóstico é uma fase importante na clínica odontológica, portanto é de suma importância que o cirurgião dentista tenha conhecimento da frequência das lesões em cavidade oral, entretanto estudos relacionados à tumores benignos é bem reduzido. Para um diagnóstico definitivo há a necessidade de exames clínicos, radiográficos, histopatológicos e imuno-histoquímico. A excisão cirúrgica é o tratamento mais considerado dependendo do tamanho da lesão, sendo que a recidiva da lesão é rara. O presente artigo buscou alertar o profissional da área médica e odontológica acerca da importância de se fazer um diagnóstico precoce de lesões cancerizáveis e ou de câncer, evitando deste modo a progressão da lesão, diminuindo a morbidade do paciente frente ao tratamento das mesmas.
SUGGESTIONS FOR EDUCATIONAL PROCESSES FROM STUDENTS WHO HAD
SUCCESSFUL QUANTITATIVE EXAM SCORES
ABSTRACT
In this research, students who had successful quantitative exam scores in the nationwide university entrance examination and thus enrolling in medicine faculties were assessed to acquire their suggestions for the educational processes. The study is a qualitative research and the data was obtained through semi-structured interviews. Due to the Covid-19 pandemic, students were reached out through their e-mails. 27 students voluntarily participated in this study. The researchers employed content analysis to the data that was obtained as written interview forms and then themes and codes were created and later interpreted. Themes regarding the results are preschool, primary school, high school and the categories are student, parents, teacher and policy-makers. For the students, the importance of playing games in preschool and primary school and attending social
activities and sports events in high school was emphasized. The students' expectations towards the high school teacher is that they should have more appropriate reactions for the developmental period. Almost all of the students stated that equality of opportunity must be applied in education. The students also stated that the academic achievement would increase if the teacher successfully facilitates qualified lessons, especially in high school when the exam anxiety of students is at its top.
Keywords: University entrance exam, quantitative score, academic achievement
INJURY CAUSES, REGIONS, TYPE, TREATMENT, RETURN TO SPORTS AND TAKE PREVENTIVE MEASURES OF TURKISH TRIathlon Athletes
To update the information about the injuries of triathlon athletes and their related parameters; discuss and evaluate current findings. This study, which examines the frequency of injury of triathlon athletes, the type of region, the treatment applied after injury and the difficulties experienced in returning to sports after injury, has a descriptive nature and was carried out according to the screening model. Existing studies were reviewed by systematic literature review, and a questionnaire based on the participant's self-report was applied. While the population of the study consisted of Turkish triathletes total number of 250, the sample consisted of 90 triathletes, 70 male and 20 female athletes, between the ages of 13-59 (31.12 ± 11.59) randomly selected from this
population. In the evaluation of the data, was used frequency and percent. 56.7% of the athletes reported that they had an injury. It was found that triathletes experienced knee, hamstring, kneeshoulder, shoulder, waist, elbow, ankle and other injuries in order of frequency. The most common causes of injury are insufficient warm-up (12.2%) and previous injury (12.2%); strain (16.7%) and muscle tear (15.6%). The results of the study show that triathletes need education about injury prevention and appropriate treatments.
Keywords: Triathlon, Injury, Rehabilitation
Dentigerous cysts are one of the most common developmental odontogenic cysts involving the unerupted or impacted tooth. Most frequently seen in 20 to 30 years of life. Cases which have been reported within 10 years of life, in mixed dentition period are hardly few in number. Here we present an interesting case of dentigerous cyst in a pediatric patient involving unerupted permanent mandibular right second premolar with an insight into differential diagnostic entities of dentigerous cyst. Complete removal of the cyst along with attached tooth structure was done under general anesthesia. Careful evaluation of the patient with past medical history, clinical, radiographic and histopathological examination would help the clinician in early diagnosis to administer appropriate treatment.
The lining or sheath of odontogenic cyst may show transformations into malignancies like squamous cell carcinoma or odontogenic carcinomas like ameloblastomas and adenomatoid odontogenic tumor. The disposition for neoplastic epithelial proliferation in the form of an ameloblastoma is far more pronounced in the dentigerous cyst. We are reporting a case of an ameloblastoma which arose in the wall of a dentigerous cyst. The aim of this paper is to highlight the fact that lesions which appear as dentigerous cyst may have component of ameloblastic changes in the lining.
Dentigerous cyst is a casual clinical findingassociated with an alteration on the eruption of canine, premolares and third molars. Itsdiagnostics is bassed on routinare periapical and panoramic Rx examinations. A space folicularbigger than 3 mm around the crown of a tooth is a reasonable approach to diagnose the lesion likecyst dentígerous. Dentígerous cyst is considered the second more frecuent maxilary odontogenic cystand represent 24% of the jaw cysts, its biggest incidence it is presented between the second andthird decade of the life and is characterized to be asymptomatic, for the expansion and loss of thecortical wall even producing facial asymmetries, radicular reabsorptions of contiguous teeth, pain,parestesia, gingival hiperplasy, infection, fistule and pathological fractures. It is recommendedthen to retire the impacted teeth to prevent the occurrence of cysts and tumors. Key words:Dentígerous cyst. Included tooth. Mandibular radiolucencies.
Özet Dental implant uygulamalarında antibiyotik kullanımı sıkça görülmektedir. Operasyon öncesi ve operasyon sonrası antibiyotik kullanımın implant sağ kalımları veya postoperatif enfeksiyonları engellemesi ile ilgili çalışmalarda çelişkili sonuçlar mevcuttur. Antibiyotik direnci toplumun en büyük risklerinden biri haline gelmiştir ve implant cerrahinde doğru bir antibiyotik protokolünün oluşturulması gerekmektedir. Bu derlemenin amacı implant cerrahisinde antibiyotik proflaksisinin etkinliğini incelemektir. Anahtar Kelimeler: Antibiyotik, dental implant, proflaksi Abstract: Antibiotic use is common in dental implant applications. There are conflicting results in studies about pre- and postoperative antibiotic use investigating implant survival or prevention of postoperative infections.Antibiotic resistance has become one of the greatest riscs to the community and an accurate antiotic protocol has to be established in dental implant surgeries This review focuses the effectiveness of antibiotic prophylaxis in the intended implant surgeon. Key Words: Antibiotic, dental implant, prophylaxis
Impacted teeth may not only interfere with function, but also can act as a source of many pathological lesions such as odontogenic cysts and tumors. One of the most prevalent types of odontogenic cysts associated with erupted, developing or impacted tooth is dentigerous cyst. Multiple impacted teeth with dentigerous cysts in both the maxillary and mandibular arches without the association of any syndromes is a very rare occurrence. In the present article, we report such a non-syndrome case of bilateral multiple impacted teeth in both maxilla and mandible with dentigerous cysts treated with enucleation and ridge augmentation with autogenous bone graft harvested from posterior iliac region. Further, dental rehabilitation was carried out with dentures.
Background:
Clinicians sometimes use decompression for secondary, low-risk cyst enucleation. The authors explored whether the decompression of dentigerous cysts associated with third molars is a reliable, long-term, definitive treatment option.
Methods:
The authors monitored 25 mandibular cysts associated with impacted third molars in adults after surgical decompression without the extraction of the related tooth for a mean (standard deviation) time of 37 (15) months (range, 12-71 months). The authors carefully evaluated the postoperative clinical situation and the extent of radiographic shrinkage.
Results:
A minimal epithelial slit remained patent in all patients. All lacked clinical problems, had no need for further intervention, and exhibited persistent impaction of the teeth. The cyst reduction rate calculated on panoramic radiographs ranged from 63.4% to 98.8% (mean [standard deviation] 87.5% [10.6%]) and was statistically significant (P < .05). In 13 patients, the reduction rate was greater than 90%.
Conclusions:
Decompression triggered marked radiographic reductions of cysts when epithelial communication persisted. The situation stabilized after the first 6 through 8 months, and no further intervention was required.
Practical implications:
It is risky to enucleate cysts associated with impacted third molars and extract the molars. Clinicians can solve the problem in dental practice by using surgical decompression.
This is the youngest patient reported in the literature with bilateral mandibular dentigerous cysts. This report confirms the importance of a panoramic radiographic examination in diagnosing bony lesions of the jaws. Early diagnosis and aggressive treatment of these lesions is essential to avoid the undesirable sequelae that could occur without treatment. Dentigerous cysts are bony lesions that have the potential to produce neoplasms.
The management of a case of bilateral dentigerous cysts of the mandible in a 9-year-old boy has been presented. The consideration of conservative treatment in this age group, combined with adequate postoperative care, has been emphasized. The postoperative results that can be obtained with the marsupialization technique have been illustrated.
The mucopolysaccharidoses (MPS) are a group of genetic lysosomal storage diseases. These diseases result from a defect in specific lysosomal enzymes required for the degradation of specific mucopolysaccharides. These incompletely degraded saccharides accumulate in tissues and are excreted in the urine. A general characteristic of these diseases is dysostosis multiplex. Dental complications can be severe and include unerupted dentition, dentigerous cystlike follicles, malocclusions, condylar defects, and gingival hyperplasia. This report examines multiple dentigerous cysts in a patient with a deficiency in N-acetylgalactosamine-4-sulfatase, Maroteaux-Lamy syndrome (MPS VI). The inability to hydrolyze the sulfate group from N-acetylgalactosamine-4-sulfate residue of dermatan sulfate due to a deficiency in this enzyme results in the accumulation of dermatan sulfate in tissues and its excretion in the urine. Examination of dentigerous cyst fluid revealed glycosaminoglycan content of 397 microgram per milliliter. Compositional analyses revealed 60% hyaluronic acid, 30% chondroitin 4- and -6-sulfate, and only 10% dermatan sulfate. This was consistent with dentigerous cyst fluid derived from persons without mucopolysaccharide-storage disorders but distinctly different from glycosaminoglycans assayed from other body fluids of this patient.
A comprehensive treatment plan, consisting of five phases, is proposed to correct the functional and esthetic defects of the craniofacial complex. Specific details of evaluation and provision of care in each of the first phases of treatment are given.
A case of bilateral subcondylar impacted mandibular third molars is presented. Both impactions had associated dentigerous cyst, one of which was severely infected with Serratia marcescens and had a draining sinus tract. The patient also had uncontrolled diabetes mellitus and iron deficiency anemia, which altered her response to surgical treatment. This case illustrates the necessity for early identification of infective organisms and determining their antibiotic sensitivity, as well as the need for prophylactic removal of impacted teeth to prevent complications such as those presented.
A 38-year-old Caucasian male with bilateral dentigerous cysts of the mandibular third molars is reported as follows. The cyst cavities were lined with a nonkeratinized squamous epithelium. Mucous cells were seen in some areas of the cyst walls.
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Cysts of the jaws, oral floor and neck In: Gorlin RJ, Goodman HW, editors. Thoma’s oral pathology
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