Mandibular Dentigerous Cyst Research Articles

Mandibular Dentigerous Cyst Without Impacted Tooth: A Clinical Rarity

Mandibular Dentigerous Cyst Without Impacted Tooth: A Clinical Rarity

The Management of a Geriatric Patient Using Dabigatran Therapy on Dentigerous Cyst with Oral Bleeding.

Jaw cysts represent a great matter of interest in oral and maxillofacial surgery. Jaw cyst surgery is a common intervention in oral surgery but, in the case of a multidisciplinary patient, the oral surgeon needs to meet with other specialists. A cyst is an epithelium-lined sac containing fluid and/or semisolid material due to epithelial cell proliferation, degeneration, and liquefaction; the hypertonic solution withdraws liquids from the surrounding tissues, while internal pressure exerts an equal strength on the cyst walls. Dentigerous cysts are the second most common odontogenic cysts after radicular cysts, and commonly few or no symptoms are reported. However, the most common diagnosis for dentigerous cyst is represented by eruption of the affected tooth or accidental diagnosis. Commonly, dentigerous cysts may be related to impacted third molars; in the case of impacted third molars and a dentigerous cyst, the tooth should be removed along with the cyst in the same intervention. Mandibular dentigerous cysts are common in children and adults, while dentigerous cysts are a rare neoformation in elderly patients. Treatment usually involves removal of the entire cyst and the associated unerupted tooth. This intervention may be more difficult if the cyst is large, the third molar is in contact with the mandibular nerve, and/or the patient has a medical history that may represent a relative or absolute contraindication. We present the case of a rare symptomatic manifestation of dentigerous cyst in an elderly patient in treatment with dabigatran therapy; for the treatment of dentigerous cysts in the elderly, we suggest a multidisciplinary approach with the use of the histological examination and a careful follow-up.

A case of a mandibular dentigerous cyst in a paediatric patient

Cystic lesions of the jaw in the paediatric population have been infrequently documented in the literature. The majority of these lesions are considered to be developmental in nature, as opposed to the commonly noted inflammatory lesions in the adults. Although asymptomatic, these lesions are associated with a high level of anxiety for parents. Early diagnosis and management help to allay anxiety. We present a case of 6-year-old boy who had a rapidly growing lucent lesion of the mandible that needed urgent intervention. The lesion was excised, analysed histopathologically, and confirmed as a dentigerous cyst. The management of paediatric cystic lesions can be difficult and vary significantly from those of the adult population. This can be amplified because cross-sectional imaging is seldom used in children owing to the risk associated with radiation. We present our experience of dealing with rapidly progressing lesion and the lessons learned in the process. CPD/Clinical Relevance: The management of paediatric cystic lesions can be difficult and vary significantly from those of the adult population.

The Successful Use of Decompression in the Management of Dentigerous Cyst: Case Report

The dentigerous cyst is reported to be one of the most common odontogenic cyst, of developmental origin, which is characterized by its association with an impacted tooth. Often assymptomatic, the dentigerous cyst presents as a well-limited unilocular radiolucent image surrounding the crown of an unerupted or impacted tooth. Decompression is a conservative treatment option for dentigerous cysts, used especially in children, to preserve the cyst associated tooth, promote its eruption and to avoid lesions of the mandibular canal. This report presents a mandibular dentigerous cyst associated with the 35 impacted tooth in a 12-year-old girl. The dentigerous cyst was successfully treated by surgical decompression.

Bilateral radicular cyst mimicking dentigerous cyst: a case report

Objectives: The aim of this case report is to describe radiographically the specific features of periapical cysts to differentiate them from dentigerous cyst lesions despite their similar clinical appearance.
 Case Report: A 21-year-old female patient came to Dental Hospital in Bandung with a referral for a cone-beam computed tomography (CBCT) examination with a clinical diagnosis of suspected right mandibular dentigerous cyst and left mandibular periapical cyst. The patient said that during the past month, swelling had appeared on both sides of the jaw, which was getting bigger, the pain was intermittent, and it was disturbing when eating. Intraoral examination showed gingival enlargement, muccobucal fold disappeared. Extraoral examination, facial asymmetry was found due to unilateral swelling. Radiographic examinations showed both lesions were oval, unilocular, radiolucent internal structures with an average density of 4.7-32 HU resembling soft tissue density, corticated or radiopaque borders, caused expansion of the mandibular corpus buccally and lingually and to mesial and distal, cortical thinning and displacement of the inferior mandibular canal.
 Conclusion: Lesions on the jaws have almost the same clinical appearance, but through CBCT examination the type of lesion can be well determined. Periapical cyst lesion with large size has a clinical appearance like dentigerous lesions, but radiographically will show a different specific picture.

Three-dimensional volumetric analysis of the efficiency of marsupialization in patients with mandibular dentigerous cysts involving impacted third molars

Oral and maxillofacial surgeons commonly encounter dentigerous cysts (DCs) in clinical practice. If the DC is large and involves vital structures, such as the inferior alveolar nerve, marsupialization can be a useful treatment option to reduce the cyst size, ensuring safer enucleation later. However, the process of postoperative cyst shrinkage remains largely unknown. We used three-dimensional (3D) computed tomography (CT) to analyze volumetric changes occurring in DCs after marsupialization. In addition, we evaluated several parameters that might influence the efficiency of volume reduction. This retrospective cohort study included 21 patients with mandibular DCs in the third molar region. Using 3D CT data obtained before and after marsupialization, we measured cyst volumes at approximately 6 and 12 months after marsupialization. All lesions gradually shrank after marsupialization. The relative velocity of volume reduction differed significantly between 6 and 12 months after marsupialization. Age was significantly related to the efficiency of cyst shrinkage at 12 months after marsupialization. The efficiency of cyst shrinkage was not correlated with sex, smoking status, tooth extraction, or CT values around the lesion. Marsupialization was effective in reducing cyst size in all patients. The efficiency of volume reduction caused by marsupialization was associated with marsupialization duration and patient age. These factors should be considered during marsupialization and subsequent follow-ups.

Multi‐disciplinary management of an unusual presentation of bilateral mandibular dentigerous cysts in a non‐syndromic child

AbstractAimBilateral dentigerous cysts of the mandible are extremely rare in non‐syndromic patients with <30 cases reported in the literature with only one involving successful orthodontic alignment of the affected teeth. This case aims to highlight a rare bilateral presentation of dentigerous cysts in a non‐syndromic child in addition to encouraging clinicians to consider multi‐disciplinary care for the management of cysts not only for successful resolution of the cystic spaces but also for subsequent successful orthodontic alignment of severely displaced teeth.Material and MethodsA 12‐year old boy was referred to the paediatric dental department at the Edinburgh Dental Institute regarding partially erupted mandibular first permanent molars with suppuration and periodontal pocketing of 12mm. Radiographic examination revealed bilateral unilocular radiolucencies of the mandible associated with the partially erupted first and unerupted second permanent molars. The treatment to date includes oral hygiene advice, bilateral incisional biopsies and marsupialisation of the lesions under general anaesthetic, expose and bond procedures of the impacted mandibular second permanent molars and maxillary and mandibular fixed appliances.ResultsBoth the first and second lower permanent molars have been successfully aligned within the arch. Histological analysis has confirmed the diagnosis of bilateral dentigerous cysts of the mandible although provisional diagnosis included bilateral keratocysts.This patient has had both clinical and radiographic follow‐up in the paediatric dental, oral surgery and orthodontic departments over a 4‐year period.ConclusionThis is a highly unusual presentation of bilateral mandibular dentigerous cysts in a non‐syndromic child. Successful multi‐disciplinary care between the paediatric, oral surgery and orthodontic departments yielded an extremely favourable outcome for this challenging case. Paediatric dentists should be aware of this unusual presentation, the subsequent appropriate referral pathway and the promising feasibility of successful orthodontic alignment of the affected teeth.

Mandibular dentigerous cyst: Enucleation and bone reconstruction – Case report

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.

Three-Dimensional Biomodels: Use of Different Materials for the Surgical Planning in Relation to Two Mandibular Cysts Cases

Introduction: The use of three-dimensional models in the diagnosis, planification and treatment of the maxillofacial area pathology has been included in publications since 1980, and has enabled to minimize surgical time, reducing peri and postoperative morbidity, and optimizing surgical results. Currently, the market offers a huge range of 3D printers and materials which allows biomodels to be printed for medical purposes. The purpose of the following paper is to describe the use of two types of three-dimensional models in the therapeutic planning of two cases of mandibular cysts. Case Report: Two cases of mandibular dentigerous cysts are described, in which osteosynthesis plates were used to prevent pathological fractures, pre-modeled together with acrylic positioners on three-dimensional models and printed in different ways. Postoperative clinical and tomographic controls were performed. Conclusion: The knowledge of the properties of the different materials available for the construction of three-dimensional models allows selecting the one that best suits the case needs required, minimizing surgical times and optimizing the results.

Managment of the mandibular dentigerous cyst plus rigid bone fixation, Presentation of a case

The objective of this article is to present the management of a patient diagnosed with a mandibular dentigerous cyst. The present case deals with a 14-year-old male patient, without relevant antecedents who attended the SERODU dental clinic, a radiolucent shadow between the dental pieces 42, 44 and 45 was included in the computerized axial tomography with the part piece No. 43 included in the symphysis of the mandibular region, horizontal position of the dental piece, the crown towards the distal and its root towards the medial with complete formation. At the crown level, a well-defined radiolucent shadow can be observed with a radiopaque halo, compatible with a dentigerous cyst. Therefore, it was decided to carry out the endodontic treatment in the dental pieces 43,44,45, subsequently the enucleation of the lesion, elimination of the dental piece, curettage and rigid bone fixation were performed, to avoid pathological complications of adjacent structures such as fracture mandibular due to the size of the lesion. A histopathological diagnosis of dentigerous cyst was obtained. At the thirty-day control, a radiopaque area compatible with bone regeneration was observed radiographically, with a radiolucent halo separating with the original basal bone. Enucleation and rigid bone fixation is an effective treatment technique to eliminate the lesion that turned out to be benign.

Bilateral mandibular dentigerous cyst in non-syndromic patient: technical strategy and literature review

Bilateral mandibular dentigerous cyst in non-syndromic patient: technical strategy and literature review

Outcome of Mandibular Dentigerous Cysts 1 to 10 Years After Decompression Using a Custom-Made Appliance

The aim of this study was to examine the long-term results of mandibular dentigerous cysts treated with decompression using a custom-made appliance. This retrospective study included 34 patients with dentigerous cysts who were treated as outpatients at the Faculty of Dentistry, Marmara University. Medical history, complaints, intraoral and extraoral clinical findings, treatment time, and complications of these patients were collected. The average age of the patients was 7.94years. Three tooth buds (canine, first permanent premolar [P1], and second permanent premolar) in 2 cases, two tooth buds in 7 cases (P1 and second permanent premolar in 6 cases and P1 and canine in 1 case), and one tooth bud in 25 cases were related to the cyst. The mean decompression time was 5.97months (range, 3 to 9months). No major complications occurred during or after decompression. No evidence of infection, breakdown and/or dehiscence of the soft tissue, or inferior alveolar nerve paresthesia was observed. The complications and complaints were minor and straightforward to resolve. Decompression is a very effective and successful method for the treatment of mandibular dentigerous cysts.

Effects of kinesiology tape after enucleation of mandibular dentigerous cysts.

ObjectivesKinesiology tape (KT) creates a pulling force on the skin, thus improving blood and lymph flow by alleviating hemorrhage and congestion of lymphatic fluid. The authors hypothesized that the use of KT could be beneficial for the management of complications after head and neck surgery and designed this study to evaluate the effects of KT on swelling, pain, and trismus after enucleation of mandibular dentigerous cysts with third molar extraction.Materials and MethodsForty patients who underwent enucleation of a dentigerous cyst with extraction of the mandibular third molar were selected. The patients were randomized into two groups (n=20 each): a KT group, where KT was applied after surgery in addition to basic postoperative care, and a control group, where patients received basic postoperative care without KT application. Swelling, pain, and trismus were evaluated before surgery (T0) and on postoperative days 1 (T1), 2 (T2), and 3 (T3). Cyst volume, gauze weight for assessing bleeding, and operation time were recorded.ResultsThere was a significant difference between the two groups in the change in swelling up to T1 and the change in swelling between T1 and T2. The maximum swelling in the KT group was significantly less than that in the No-KT group and maximum swelling appeared faster in the KT group than in the No-KT group. Both groups showed a mild pain response but there was no significant difference between the two groups. There was no significant difference on interincisal distance change between the two groups. There were no correlations between cyst volume, bleeding, operation time, and maximum swelling.ConclusionKT can effectively manage facial swelling after oral and maxillofacial surgeries such as cyst enucleation and third molar extraction, thus improving postoperative patient satisfaction levels and quality of life.

Cyst volume changes measured with a 3D reconstruction after decompression of a mandibular dentigerous cyst with an impacted third molar.

The aim of this article is to describe a large mandibular cyst treated with decompression followed by surgical enucleation. Furthermore, we described the utility of cyst volume measurements by using a 3D reconstruction on Cone Beam Computed Tomography (CBCT). The dentigerous cyst is the most common cyst type of epithelial origin, arising from remnants of odontogenic epithelium, asymptomatic and associated with the crown of an unerupted or partially or completely impacted tooth. However, after a long duration and extension of the cyst volume it may provoke significant bone resorption, cortical expansion, tooth displacement and the vitality of neighboring teeth may be affected. The regular treatment of this lesion is enucleation and extraction of the involved tooth. Marsupialization and decompression are proposed when the volume of the cyst is well developed to release the cystic pressure and allow the bone cavity to progressively decrease in volume with the gradual apposition of bone. This report presents a large dentigerous cyst related to impacted mandibular third molar of a 21-year-old male patient. The cyst was treated successfully by decompression and later by surgical enucleation with surgical extraction of the related molar. In conclusion, the combination of decompression and surgical approach showed on the three-dimensional CBCT investigation a significant correlation between the treatment and volume reduction of the cyst. The clinical case described allows us to observe bone formation after decompression and surgical enucleation was performed with less risk on vital anatomic elements.

Wait or Intervene: Dentigerous Cyst Associated with Permanent Mandibular Canine

Dentigerous cysts are developmental odontogenic jaw cysts. Dentigerous cysts require early detection and prompt treatment ranging from marsupialization to complete enucleation. Few of these cysts have been reported in children younger than 12 years of age. The purpose of this case report was to describe the case of an 11-year-old boy with a dentigerous cyst associated with unerupted right mandibular canine. The clinical, radiographic and histopathologic features are discussed. This case report also describes the diagnosis of a mandibular dentigerous cyst using cone beam computed tomography, successful use of conservative enucleation and explains the need for such a radical treatment approach.

A giant mandibular dentigerous cyst associated with a compound odontoma: A case report

A giant mandibular dentigerous cyst associated with a compound odontoma: A case report

Bilateral mandibular dentigerous cysts: a case report

Dentigerous cysts are frequently found in the maxilla. After radicular cysts, dentigerous cysts are those most commonly diagnosed, accounting for 20% of all jaw cysts. They are often asymptomatic and diagnosed incidentally during routine examinations. Clinical complications such as dental displacement, ectopic eruption, dental impaction, adjacent tooth root resorption, cortical expansion with facial asymmetry, paresthesia, pathological fracture, and even malignant transformation may occur. Despite these classical features, definitive diagnosis must always be based on histological examination. Most dentigerous cysts are solitary. The aim of this article is to report a case of bilateral mandibular dentigerous cysts in a non-syndromic patient and, through a literature review, present the available treatment modalities used successfully in this case.

Conservative treatment of dentigerous cyst associated with primary teeth

Dentigerous cyst is the most common odontogenic cyst. It is characterized by a unilocular radiolucent lesion that encloses permanent tooth buds or, under certain circumstances, displaced tooth buds. Buccal bony expansion is the most common clinical feature. Several treatment modalities have been mentioned in the literature for management of dentigerous cysts. The purpose of this article was to report an extensive right mandibular dentigerous cyst on a 10-year-old boy. Marsupialization was chosen to preserve the permanent tooth bud and a denturelike obturator was then provided for space maintenance and masticatory function. Long-term follow-up revealed good healing of the bony lesion with converted tooth eruption.

Decompression, Enucleation, and Implant Placement in the Management of a Large Dentigerous Cyst

The dentigerous cyst is a developmental odontogenic cyst, accounting for 10% of all cysts of the jaws. The treatment options are decompression, marsupialization, or enucleation regarding the features of the lesions. In this article, a case of a 17-year-old adolescent girl having a large mandibular dentigerous cyst associated with an unerupted third molar is presented. The treatment is composed of decompression for 6 months and enucleation. Decompression and enucleation are a predictable choice in the treatment of large cysts. Radiologic evaluation is mandatory to decide for the appropriate time for the removal of the decompression stents, the enucleation time, and also for the evaluation of the adequate new bone formation for implant placement. The present case emphasizes the success of a conservative approach in the management of a large dentigerous cyst in a young patient and also the maintenance of the new bone formation without using any graft materials for the placement of dental implants.

Cholesterol granuloma in the wall of a mandibular dentigerous cyst: a rare case report

Cholesterol granuloma is an inflammatory reaction to cholesterol crystals deposition. It may develop in a variety of sites including the middle ear, mastoid process or even paranasal sinuses. Very few cases of cholesterol granuloma occurring in the jaws were reported. This report presents a rare case of cholesterol granuloma that developed in the wall of a large mandibular dentigerous cyst. The condition was treated with hemimandibulectomy followed by reconstruction with a free fibular flap.