Dentigerous Cyst Associated with an Ectopic Tooth in the Subcondylar Area: A Case Report and Literature Review

Abstract

Dentigerous cysts associated with an ectopic third molar in the subcondylar area are fairly rare, and information is limited about its causes and characteristics. This article reports a case of dentigerous cysts associated with an ectopic third molar in the subcondylar and reviews the literature on the clinical signs and symptoms and different treatment methods of this condition. We report a case dentigerous cyst associated with an ectopic mandibular third molar in the subcondylar area. 14 cases of dentigerous cysts associated with an ectopic third molar in the subcondylar area reported in the English-language literature over the past 30 years, identified from Medline databases are also reviewed. We found a mean age at diagnosis of 48.1 years and a higher prevalence in women. Facial pain and swelling on the preauricular region or ipsilateral side of the mandible were the most common symptoms. Among the 14 case reports identified, 7 were by an extraoral approach and 7 were by an intraoral approach. The most commonly used extra-oral approaches are retromandibular. The etiology of ectopic mandibular third molars has not yet been completely clarified. They must be removed if they cause symptoms or are associated with cystic pathology. The treatment of third molars in the condylar region is divided into conservative and, in most cases, surgical removal by intra or extra-oral route. The surgical approach must be carefully planned according to the location and position of ectopic third molars.

Comprehensive analysis of ectopic mandibular third molar: a rare clinical entity revisited

“…Consistent with previous reports, most ectopic mandibular third molars were found simultaneously with pathological lesions like odontogenic cysts or tumors [ 2 , 27 , 40 ]. On the panoramic images, the tooth crown was typically surrounded by radiolucent lesions (odontogenic cysts) or the tooth was embedded into the lesion [ 29 , 47 ].…”

“…Most of the reported cases were found associated with radiolucent lesions in the panoramic radiograph and confirmed histopathologically as cysts or tumors. In the present patient cohort and the cases mined from literature, the overweighing majority of ectopic teeth is found simultaneously with odontogenic cysts or tumors [ 40 ]. The pressure resulted from these associated lesions displaces tooth buds in an abnormal direction which were further developed in the ectopic region [ 25 , 37 ].…”