Unusual Imaging Features of Dentigerous Cyst: A Case Report

Abstract

Dentigerous cysts (DC) are cystic lesions radiographically represented by a well-defined unilocular radiolucent area involving an impacted tooth crown. We present an unusual radiographic feature of dentigerous cyst related to the impacted mandibular right second molar, in a 16-year-old patient, which suggested an ameloblastoma or odontogenic keratocyst (OKC) because of its multilocular appearance seen on the panoramic radiography. A multi-slice computed tomography (MSCT), however, revealed a unilocular lesion without septations, with an attenuation coefficient from 3.9 to 22.9 HU suggesting a cystic lesion. Due to its extension, a marsupialization was performed together with the histopathological analysis of the fragment removed which suggested a dentigerous cyst. Nine months later, the lesion was reduced in size and then totally excised. The impacted mandibular right second molar was also extracted. Histopathological examination confirmed the diagnosis of a dentigerous cyst. One year later, the panoramic radiography showed a complete mandible bone healing. Large dentigerous cysts can sometimes suggest other more aggressive pathologies. Precise diagnosis is important to avoid mistakes since DC, OKC and ameloblastoma require different treatments. Histological examination is, therefore, essential to establish a definitive diagnosis. In our case, MSCT and the tissue attenuation coefficient analysis contributed to guide the diagnosis and management of the dentigerous cyst.

Uncommon involvement of multiple lesions in the oral cavity: A case report

“…It is known that panoramic radiography is a useful aid for diagnoses, but it only shows two-dimensional images of three-dimensional structures. In addition, it has a limited value to determine the lesion size and margins tissue composition, as well as bone destruction and expansion patterns (Martinelli-kläy et al, 2019), therefore it must be associated with other exams. As the concomitant presentation of these lesions does not have the same etiology, despite their particular appearance, the approach followed the most suitable treatments for each lesion, respecting their biological behavior.…”

Dentigerous Cyst in the Maxillary Anterior Region of a Pediatric Patient

“…It is mainly associated with the mandibular third molar, maxillary third molar and maxillary canines, with peak incidence in the second and third decades. 1 The occurrence of this cyst in the first decade is relatively low at approximately 4 to 7%. Histologically, they are represented by a cavity lined by the nonkeratinizing thin epithelium without rete pegs.…”

Temuan kista dentigerus rahang atas dengan perluasan kavum nasal dan sinus maksilaris melalui CBCT dan panoramik radiograf

“…Gambaran CBCT pada kasus ini memperlihatkan adanya perluasan lesi ke kavum nasal dan sinus maksilaris sinistra, posisi gigi supernumerari yang impaksi serta resorpsi eksternal pada akar gigi insisif sentral kanan yang tidak terlihat pada gambaran panoramik. 12 CBCT memiliki dosis radiasi yang lebih besar dibandingkan panoramik, namun pada pemeriksaan panoramik yang dilakukan tidak dapat menggambarkan perluasan lesi secara detail (3 dimensi) selain itu pemeriksaan panoramik tidak dapat memperlihatkan tanda-tanda spesifik dari lesi seperti pada kasus. CBCT memiliki keuntungan yang lebih baik dibandingkan panoramik.…”