UNERUPTED DECAYED TOOTH: A RARE CASE

Abstract

Pre-eruptive intracoronal radiolucencies are a rare occurrence, detected occasionally on routine radiographs. The etiology is still unclear, but evidence suggests that these lesions have resorptive nature, not associated with caries. A 35-year-old female patient presented a radiolucent lesion around the crown of an unerupted tooth (with resorbed crown and roots) between the roots of teeth #13 and #15 (radicular remnant with endodontic treatment). With the clinical hypotheses of dentigerous cyst and odontogenic keratocyst, an excisional biopsy was performed. Microscopic examination revealed fragments of connective tissue capsule with intense inflammation partially covered by stratified nonkeratinized squamous epithelium. The removed unerupted tooth presented dentin destruction with foci of liquefaction containing bacteria, areas of dentin resorption, and tertiary dentin, in addition to bacterial colonies similar to Actinomyces. The diagnosis was inflamed odontogenic cyst associated with an unerupted decayed tooth, which may be explained by the infection of tooth #15. Pre-eruptive intracoronal radiolucencies are a rare occurrence, detected occasionally on routine radiographs. The etiology is still unclear, but evidence suggests that these lesions have resorptive nature, not associated with caries. A 35-year-old female patient presented a radiolucent lesion around the crown of an unerupted tooth (with resorbed crown and roots) between the roots of teeth #13 and #15 (radicular remnant with endodontic treatment). With the clinical hypotheses of dentigerous cyst and odontogenic keratocyst, an excisional biopsy was performed. Microscopic examination revealed fragments of connective tissue capsule with intense inflammation partially covered by stratified nonkeratinized squamous epithelium. The removed unerupted tooth presented dentin destruction with foci of liquefaction containing bacteria, areas of dentin resorption, and tertiary dentin, in addition to bacterial colonies similar to Actinomyces. The diagnosis was inflamed odontogenic cyst associated with an unerupted decayed tooth, which may be explained by the infection of tooth #15.