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Case Reports
. 2025 Jul 3:2025:2436615.
doi: 10.1155/crid/2436615. eCollection 2025.

A Rare Case Report of a Large Dentigerous Cyst in the Maxillary Sinus Associated With an Ectopic Maxillary Third Molar

Marika Ramishvili  1 , Leila Atskvereli  2   3 , Giorgi Menabde  1 , Marika Zurmukhtashvili  4 , Sopio Samkharadze  4 , Giorgi Dugashvili  5 , Luc Marks  6   7
Affiliations
Case Reports

A Rare Case Report of a Large Dentigerous Cyst in the Maxillary Sinus Associated With an Ectopic Maxillary Third Molar

Marika Ramishvili et al. Case Rep Dent. .

Abstract

Ectopic eruption of permanent molars is an uncommon developmental anomaly characterized by abnormal tooth positioning, which can lead to significant complications. In rare instances, ectopic molars may be associated with dentigerous cysts, particularly within the maxillary sinus, posing challenges for diagnosis and management. This report discusses a rare case of a 58-year-old male who presented with chronic right maxillary sinusitis, intermittent facial pain, and purulent nasal and oral discharge. Radiological evaluation, including cone beam computed tomography (CBCT), revealed a completely opacified right maxillary sinus containing an ectopic maxillary molar. Additionally, a large cystic lesion consistent with a dentigerous cyst was found, occupying the entire sinus cavity. Surgical management was performed using the Caldwell-Luc approach under general anesthesia. This involved creating a bone window in the anterior maxillary wall to facilitate the removal of the ectopic tooth and the associated cystic lesion. Histopathological examination confirmed the presence of a dentigerous cyst exhibiting chronic inflammatory infiltration and fibrosis. Ectopic molars in the maxillary sinus are often asymptomatic but can present with recurrent sinusitis, pain, and oroantral communication. The existence of a large dentigerous cyst heightens the risk of complications and may obscure radiological interpretation due to sinus opacification. This case highlights the necessity of comprehensive imaging and early surgical intervention to prevent long-term complications. Awareness of such rare conditions can help clinicians in prompt diagnosis and appropriate management, ultimately preserving sinus function and minimizing further issues.

Keywords: Caldwell–Luc approach; cystic lesion; intrasinusal position of the molar; maxillary sinusitis; sinus opacification.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Preoperative dental panoramic radiograph showing ectopic tooth (arrow) in the right maxillary sinus.
Figure 2
Figure 2
Preoperative cone beam computer tomography image showing ectopic tooth (white arrows) in the right maxillary sinus. (A) Coronal view. (B) Sagittal view. (C) Axial view. (D) 3D reconstruction.
Figure 3
Figure 3
Preoperative cone beam computer tomography images (the best visualizations) showing ectopic tooth (white arrows) in the right maxillary sinus. (A) Coronal view. (B) Sagittal view.
Figure 4
Figure 4
The best view of 3D reconstruction showing ectopic tooth (white arrow) in the right maxillary sinus.
Figure 5
Figure 5
Intraoperative photographs. (A) Soft tissue flap is mobilized. (B) Bone window is formed (arrows). (C) Ectopic molar (arrow) removal. (D, E) Extirpation of the cyst wall (cyst—arrows). (F) Pledget in the nasal cavity (arrows). (G) Wound after suturing (arrows).
Figure 6
Figure 6
Extirpated ectopic molar (black arrow) and objects of inflamed mucosa of the sinus (yellow arrow).
See this image and copyright information in PMC

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