An Unusual Case of Tooth in the Floor of the Orbit: The Libyan Experience

Abstract

Maxillary dentigerous cysts although uncommon need to be considered in the differential diagnosis in children with painless facial swelling. We present a case of dentigerous cyst associated with maxillary deciduous canine and maxillary premolars manifesting as a unilateral swelling in canine region of the face. A ten-year-old boy came to oral and maxillofacial surgery unit with a painless left facial swelling. The local dentist had prescribed antibiotics for treatment for the facial swelling, but the swelling did not subside, and the parents brought the child to our unit in Zliten Dental College. After clinical examination and imaging, the diagnosis of dentigerous cyst was made. Caldwell-Luc approach was done, the cyst was enucleated, and primary closure was done. The patient was followed up for a period of two years and there was no evidence of any recurrence.

Unusual case of concomitant occurrence of Tessier′s number 7 cleft and dentigerous cyst

“…Most of the maxillary cysts arise as a result of defect in the embryonal development which occurs either as abnormalities in the fusion of facial processes or due to the abnormal developmental of the dental follicle. [ 14 ] Both of these were seen in our patient where the Tessier's number 7 cleft arose due the defect in the fusion of the facial processes and the dentigerous cyst may have developed due to the abnormal development of the dental follicle.…”

“…[ 12 ] The dentigerous cysts, which involve the maxillary canine often extend into the maxillary sinus or to the orbital floor as was seen in our case. [ 14 ] The exact histogenesis of dentigerous is not clear[ 11 ] and numerous theories have been proposed regarding its histogenesis. Most of the maxillary cysts arise as a result of defect in the embryonal development which occurs either as abnormalities in the fusion of facial processes or due to the abnormal developmental of the dental follicle.…”

What Do We Know About Dentigerous Cysts in Children, A Review of Literature

“…Only one case reported the use of nitrous oxide with general and local anaesthesia [96]. Some of the included clinical studies did not mention the type of anaesthetic technique used [10,14,16,17,21,35,36,39,42,44,46,49,50,51,54,55,57,59,66,68,70,74,78,79,81,82,85,89,90,93,98,102,103]. In one study the extracted tooth was re-planted after the marsupialization, however there was no enough long term follow-up [16].…”