A Case Series of Dentigerous Cyst in Paediatric Patients at Our Tertiary Institution

Abstract

Dentigerous cysts involves erupted or developing teeth in decreasing order of frequency as mandibular third molars, the maxillary canines, the maxillary third molars with rare involvement of the central incisors & are usually asymptomatic but becomes symptomatic with symptoms such as swelling, mild sensitivity, tooth mobility and displacement when it reaches size > 2 cm in diameter. Dentigerous cysts are seen most commonly in 20-30 years age group with relative low frequency in children with proportion of 4-9% of these cysts occur in the first 10 years after birth. Hospital based study conducted in the Department of ENT at Ashwini Rural medical college & Hospital, Solapur in which we have reported a series of three cases of dentigerous cyst in paediatric patients. Dentigerous Cysts in our study were associated with maxillary permanent lateral incisor, mandibular permanent premolar, Mandibular second molar tooth in pediatric age group. Provisional diagnosis of Dentigerous cyst based on clinical, radiological & biochemical study but Histopathological examination confirms the diagnosis. Dental orthopentamogram aids in diagnosing and localizing the Dentigerous cyst and ct face in all views helps to see bony effects and complications due to expansion of Dentigerous cyst. Enucleation of the cystic lesion followed by extraction of the offending teeth is a suitable treatment modality for Dentigerous cyst associated with maxilla and mandible giving adequate balance between complete removal of cyst & giving chance for eruption of unerupted teeth.

Keywords: Dentigerous cyst; Enucleation; Lateral incisor; Orthopentamogram.

Fig. 1

a Preoperative external photograph of patient showing swelling over left cheek region. b Preoperative intraoral photograph showing bulge at upper left gingivolabial sulcus

Fig. 2

a Preoperative Dental OPG of the patient b Preoperative CT face of the patient

Fig. 3

Intraoperative photograph showing Dissected Dentigerous cyst all around which is arising from unerupted Permanent left upper lateral incisor teeth

Fig. 4

Postoperative intaoral photograph after reposition of left upper gingivolabial flap and closure in layers

Fig. 5

Tissue specimen showing dentigerous cyst along with upper left permanent lateral incisor tooth within it

Fig. 6

Histological section of the specimen showing dentigerous cyst with its hyperplastic epithelial lining & underlying connective Tissue (H&E staining, original

Fig. 7

Postoperative Dental OPG

Fig. 8

Preoperative intraoral photograph showing bulge at lower left gingivolabial sulcus

Fig. 9

Preoperative CT face of the patient showing hollow cavity approx 20 × 36 mm in size below left mandibular deciduous molar tooth

Fig. 10

Intraoperative photograph showing Dissected Dentigerous cyst all around which is arising from left first permanent premolar tooth

Fig. 11

Tissue specimen showing left first permanent premolar tooth and entire dentigerous cyst wall

Fig. 12

Preoperative CT face of the patient showing hollow cavity along with roots of second molar tooth

Fig. 13

Intraoperative photograph showing dentigerous cyst causing bulge at the left gingivolabial sulcus

Fig. 14

Tissue specimen showing second molar tooth in the wall of dentigerous cyst