Dentigerous Cyst

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Definition

Odontogenic cyst associated with unerupted tooth in young adults.

Clinical Features

Usually young adult
Symptoms:
- swelling
- rarely, pain
- occur late or with infection and inflammation

Pathogenesis

Odontogenic:
- arises from alterations of reduced enamel epithelium after development of enamel

Gross Pathology

Surround or associated with unerupted teeth
Associated with the tooth crown, at least initially
Present in almost 1% of individuals having complete dental radiographs1–3

Histopathology

Thin fibrous wall lined by keratinized stratified squamous epithelium 1
Secondary changes common in form of:
- chronic inflammation
- ulceration
- reactive hyperplasia
- metaplasia
- calcification
- clusters of histiocytes containing hemosiderin and lipofuscin2,4
Dysplasia and carcinoma can develop 5–7

Differential Diagnosis

Select up to 2 differential diagnoses to compare with Dentigerous Cyst

Other epithelium-lined cysts of maxilla or mandible8–12

Management

Surgical excision:
- treatment of choice
Recurrence very unusual and if occurs consider:
- failure to recognize ameloblastoma in early or cystic example 13

References

1 Cabrini RL, Barras RE, Albano H. Cysts of the jaw. A statistical analysis. J Oral Surg. 1970;28:485–489.

2 Gorlin RJ. Cysts of the jaws, oral floor, and neck. Gorlin RJ, Goldman HM editor. Thoma's oral pathology. 6th ed.. St. Louis: Mosby; 1970.

3 Killey HC, Kay IW. An analysis of 471 benign cystic lesions of the jaws. Int Surg. 1966;46:540–545.

4 Wright JM. Squamous odontogenic tumor-like proliferation in odontogenic cysts. Oral Surg Oral Med Oral Pathol. 1979;47:354–358.

5 Browne RM, Gough NG. Malignant change in the epithelial lining of odontogenic cysts. Cancer. 1972;29:1199–1207.

6 Chretien PB, Carpenter DF, White NS, Harrah JD, Lightbody PM. Squamous carcinoma arising in a dentigerous cyst. Presentation of a fatal case and review of four previously reported cases. Oral Surg Oral Med Oral Pathol. 1970;30:809–816.

7 Eversole LR, Sabes WR, Rovin S. Aggressive growth and neoplastic potential of odontogenic cysts. With special reference to central epidermoid and mucoepidermoid carcinomas. Cancer. 1975;35:270–282.

8 Regezi JA, Courtney RM, Batsakis JG. The pathology of head and neck tumors. Part 12. Cysts of the jaws. Head Neck Surg. 1981;4:48–57.

9 Gardner DG, Sapp JP, Wysocki GP. Odontogenic and “fissural” cysts of the jaws. Pathol Annu. 1978;13(Pt 1):177–200.

10 Gorlin RJ. Potentialities of oral epithelium manifest by mandibular dentigerous cysts. Oral Surg Oral Med Oral Pathol. 1957;10:271–284.

11 Moursh F. A roentgenographic study of dentigerous cysts. Oral Surg Oral Med Oral Pathol. 1964;18:466–473.

12 Shear M. Cysts of the oral region. Bristol: John Wright & Sons, Ltd.; 1976;.

13 Vickers RA, Gorlin RJ. Ameloblastoma. Delineation of early histopathologic features of neoplasia. Cancer. 1970;26:699–710.

Last updated: 29 Oct 2006