Dentigerous cyst formation following trauma to the primary incisors: A case report.

Although usually considered to be of developmental origin, dentigerous cysts (DCs) have been reported to form in response to chronic periapical inflammation associated with primary teeth that have necrotic, infected pulps. This article describes the management of a DC associated with tooth 21 in a seven-year-old Caucasian child with a history of multiple TDIs to the primary maxillary incisors. Chronic periapical inflammation associated with a necrotic pulp in tooth 61 was identified as the likely cause of the lesion. Initial conservative management involved marsupialization of the lesion by extracting the necrotic tooth 61. Following significant decompression of the cyst, surgical enucleation was carried out under general anaesthesia and an orthodontic attachment was bonded to the crown of the unerupted tooth 21 to facilitate traction. Histopathological assessment of the enucleated tissue confirmed it to be a DC. Two years after the initial presentation, teeth 21 and 22 had erupted into the oral cavity, improving patient aesthetics. However, the root of tooth 22 was transposed with the crown of the unerupted tooth 23. This case highlights the undesirable sequelae that may occur following delayed and inappropriate management of TDIs.

Inflammatory dentigerous cyst of mandibular first premolar associated with endodontically treated primary first molar: a rare case report.

AIM: Inflammatory dentigerous cysts usually occur in the mixed dentition. It has been reported that inflammatory lesions from the root area of a deciduous tooth bring about the development of dentigerous cysts around the unerupted permanent tooth bud. Endodontic treatment is a common and successful procedure for periapical inflammation in children. An inflammatory dentigerous cyst can occur in conjunction with endodontically treated primary tooth. CASE REPORT: This article reports a case of 6 years and 6 months old boy, with a single, well-defined, unilocular, radiolucent area enclosing the first right unerupted mandibular premolar, accidentally discovered on the panoramic radiograph. The first right primary molar had received a root canal treatment 18 months prior. Clinical findings combined with radiographic and microscopic examinations confirmed the diagnosis of inflammatory dentigerous cyst. As treatment, enucleation of the cyst with removal of the involved permanent tooth was chosen and a removable partial denture was supplied to the patient after surgery. The 5-year follow-up revealed good healing of the bony lesion and displaced teeth. CONCLUSION: This case presented a severe and rare complication of endodontically treated primary tooth, and the recommendation includes: (1) early diagnosis of dentigerous cysts, which is essential to prevent extensive treatment; (2) more information on the adverse side effects of an endodontic treatment should be given to patients and parents; (3) patients should be informed about the importance of follow-ups and radiographic follow-up should be routinised.

Endodontic therapy of a mandibular canine tooth with irreversible pulpitis secondary to dentigerous cyst.

Dentigerous cysts are uncommon, yet are being reported with increasing frequency in the veterinary literature. Dentigerous cysts are a type of benign odontogenic cyst associated with impacted teeth, most commonly the mandibular first premolar tooth. Significant bone destruction can occur secondary to the expansion of a dentigerous cyst. The expanding cyst can lead to pathology of neighboring teeth, which can include external root resorption or pulpitis. Intraoral dental radiographs are imperative to properly assess the presence and extent of a dentigerous cyst, as well as the status of the neighboring teeth. This case report describes treatment for dentigerous cyst including cyst lining curettage, mandibular bone regeneration, and endodontic therapy for a canine tooth with irreversible pulpitis.

[Large dentigerous cyst caused by retained tooth 25]. / Duza torbiel zawiazkowa spowodowana zatrzymanym zebem 25.

Follicular cysts are benign, non-inflammatory odontogenic cysts, usually painless and discovered during routine radiographic examination. The article describes a case of a large follicular cyst with retained tooth 25. Pantomographic x ray showed the presence of a large follicular cyst located on the side of the impacted 25 tooth. The cyst has been enucleated and the tooth extracted surgically with subsequent closure of oro-antral communication. After 3 months orthodontic treatment was initiated.

Dental impactions related to pseudoxanthoma elasticum.

Pseudoxanthoma elasticum is a rare genetic disorder causing degeneration and calcification of elastic fibers, leading to injuries in the skin, retina, and cardiovascular system. This report describes a case of a 30-year-old woman whose diagnosis of pseudoxanthoma elasticum was confirmed after a skin biopsy. The patient presented at the Clinical Management Unit of the Department of Oral and Maxillofacial Surgery, Virgen del Rocio Hospital (Seville, Spain) with pain related to a semi-erupted lower first molar. Radiologic examination disclosed multiple dental impactions. Cases of oligodontia, amelogenesis imperfecta, and mucosal lesions related to pseudoxanthoma elasticum were found in the current literature, but there were no reports of multiple dental impactions.

Dentigerous cyst of inflammatory origin-a diagnostic dilemma.

Odontogenic cysts commonly encountered in dental practice are the radicular cysts and dentigerous cysts. Apart from the developmental origin of dentigerous cysts, an inflammatory origin has also been suggested. It has been reported that inflammation progressing from the root apex of the deciduous tooth brings about development of the dentigerous cyst around the unerupted permanent tooth. The aim of the present article is to report 4 additional cases of dentigerous cyst believed to be of inflammatory origin and to highlight the diagnostic dilemma in segregating both the entities. The 4 cases were of patients with a mixed dentition with the pathology related to the deciduous tooth present. Radiographically, pericoronal radiolucency was seen attached at the cementoenamel junction of impacted tooth and in continuation with lamina dura of deciduous tooth. Microscopically, the cystic cavity was lined by reduced enamel epithelium like lining, which was hyperplastic to anastomosing in areas in few cases. This study proposes the predicament in accurately diagnosing such cases.

[Dentigerous cyst associated with a wisdom tooth in the maxillary sinus. Case reports, review of the literature]. / Arcüreg felé attöro, follikuláris cisztával körülvett bölcsességfogak. Esetismertetés, irodalmi attekintés.

Wisdom teeth are often impacted or in an ectopic position. One rather special localisation is the maxillary sinus. Usually these teeth are associated with dentigerous cysts, which can occupy the maxillary sinus partially or totally and can be the cause of various symptoms. We can find it at routine radiographic examination or the patient could have typical, sinus-related symptoms. This signs can be swelling, pain of the cheek, headeache and nasolacrimal obstruction. We report four cases (one of them detailed) with review of the literature where the upper wisdom tooth is situated in the maxillary sinus.

Ectopic tooth in maxillary sinus compressing the nasolacrimal canal: A case report.

RATIONALE: Ectopic tooth is tooth erupting out of normal anatomical position. Ectopic tooth can occur in different positions, such as maxillary sinus and nasal cavity. In this article, we present a rare case of an ectopic tooth with a dentigerous cyst in the maxillary sinus compressing the nasolacrimal canal. PATIENT CONCERNS: An 8-year-old girl presented with a 2-month history of spontaneous lacrimation in her right eye. When she wept, more tear shed from her right eye than that from the left one. Computed tomographic (CT) imaging showed a huge low-density image containing a tooth in the maxillary sinus in her right maxilla; the right nasolacrimal canal vanished due to the compression of the ectopic tooth. DIAGNOSES: Ectopic tooth with dentigerous cyst of right maxilla, and obstruction of nasolacrimal duct. INTERVENTIONS: The patient underwent nasal endoscopic maxillary sinus cystectomy. OUTCOMES: The patient recovered well after cystectomy and has been symptom-free. LESSONS: The unique finding is that this is the first report about ectopic tooth compressing the nasolacrimal canal and inducing spontaneous lacrimation. Treatment: aspect: surgery under endoscope is a minimally invasive approach to ectopic tooth.

Trauma-induced dentigerous cyst involving an inverted impacted mesiodens: case report.

There have been only a small number of studies on the association of dentigerous cysts with supernumerary teeth. The purpose of this article was to report the case of a dentigerous cyst associated with an impacted inverted mesiodens that developed secondary to trauma to its predecessor, a non-vital permanent maxillary central incisor. As a consequence of trauma, the central incisor's root development was prematurely arrested and the open apex lay close to the follicle of the underlying inverted mesiodens. The negligent attitude of both the child and parent in seeking dental treatment was a contributing factor. The case was further complicated by impaction of the adjacent permanent central incisor due to the presence of another unerupted but normally oriented mesiodens. Occlusal and Intraoral periapical radiographs revealed a well-defined radiolucent area surrounding the inverted mesiodens. Microscopic examination revealed a cystic cavity that was lined by 2-3 cell thick non-keratinized stratified squamous epithelium resembling reduced enamel epithelium. Dentigerous cysts associated with impacted permanent teeth are not uncommon but the cysts which are induced by trauma are uncommon. Development of trauma-induced dentigerous cyst around an inverted impacted mesiodens associated with the periapical area of a traumatized, non-vital, immature permanent central incisor is a rare occurrence.

Hereditary osteodystrophy with multiple hormone resistance--a case report.

Hereditary Osteodystrophy, also called pseudohypoparathyroidism, Type 1A (PHP), is a very rare condition composed of a heterogeneous group of autosomal dominant disorders with the common feature of organ resistance to multiple hormones. These patients produce the right amount of hormones but there is resistance to its effect. PHP is difficult to diagnose and the lack of diagnosis may have serious implications for the patient. We report a case of PHP, diagnosed by the dentist, due to the dental and jaw manifestations.

Bilateral Mandibular Dentigerous Cysts Presenting as an Incidental Finding: A Case Report.

BACKGROUND Dentigerous cysts are slow-growing odontogenic cysts that usually develop unilaterally as part of a pre-existing syndrome. Non-syndromic bilateral dentigerous cysts are extremely rare, but clinicians should be aware of this condition to ensure prompt diagnosis and management and to prevent complications. CASE REPORT A case is presented of bilateral mandibular dentigerous cysts that were discovered incidentally in a 44-year-old man who presented for extraction of a retained maxillary deciduous tooth. Histological examination of the tissue specimens following bilateral enucleation confirmed the diagnosis of bilateral dentigerous cysts. CONCLUSIONS In this case, incidental bilateral dentigerous cysts were identified and treated by enucleation. The absence of an associated syndrome should not exclude the possibility of the diagnosis of dentigerous cysts, which should be removed to prevent future complications.

Conservative management of a dentigerous cyst secondary to primary tooth trauma.

Pulp necrosis is a commonly observed sequela in traumatized primary teeth and is one of the possible etiologic factors for the development of dentigerous teeth. This article reports the case of a dentigerous cyst associated with the germ of a permanent maxillary central incisor that developed secondary to trauma to the predecessor primary incisor. The therapeutic approach included endodontic treatment of the primary tooth and marsupialization of the lesion. After 36 months of follow up, the permanent incisor presented with normal physiologic conditions, absence of dental anomalies and erupted in its correct position in the oral cavity. In conclusion, with proper case selection, marsupialization might be a good treatment option for conservative management of dentigerous cysts.

Dentigerous cyst associated with a formocresol pulpotomized deciduous molar.

This report presents a case of dentigerous cyst associated with a formocresol pulpotomized deciduous molar detected during routine examination. Dentigerous cyst is an epithelial-lined developmental cavity that encloses the crown of an unerupted tooth at the cementoenamel junction. The present case describes a 9-year-old girl sent to the dental clinic by her dentist, who had accidentally discovered in the panoramic radiograph a single, unilocular, well-defined, radiolucent area enclosing the second left unerupted mandibular premolar. The second left primary molar had been pulpotomized 2 years before and buccal swelling without redness occurred near the tooth, evidencing bone expansion. Surgical treatment was carried out, the tooth was extracted, and a cystectomy was performed under local anesthesia in the dental office. The histological study confirmed the suspected diagnosis of dentigerous cyst. The relation between pulpotomy and dentigerous cysts is discussed.

Angiogenesis concept in odontogenic keratocyst: A comparative study.

CONTEXT: Recent reports have indicated that angiogenesis possibly affects the biologic behavior of the lesions. AIM: Given the different clinical behaviors of odontogenic keratocyst (OKC), the present study was undertaken to evaluate the concept of angiogenesis in pathogenesis and clinical behavior of OKC. SETTING AND DESIGN: This experimental study was carried out on 22 and 24 samples of OKCs and dentigerous cysts (DCs), respectively. METHODS: Immunohistochemical staining was approached using CD34 and vascular endothelial growth factor (VEGF) antibodies. The expression of VEGF was first reported by determining the counts of stained cells, including epithelial cells, fibroblasts, and endothelial cells, followed by the percentage of stained cells in each sample based on a 0-2 scoring system. The counts of CD34+ cells were reported in each group in the form of means ± standard deviations. In addition, the patterns of blood vessels in the samples prepared from the walls of both cysts were evaluated. STATISTICAL ANALYSIS USED: Mann-Whitney U-test, Chi-squared test, and t-test were used for analysis of data, and statistical significance was defined at p < 0.05. RESULTS: The expression percentage and scores of VEGF and the mean expression rate of CD34 were significantly higher in OKCs than DCs (p = 0.045, 0.000, and p = 0.58). Finally, there was a strong correlation between the expressions of the two markers in the samples (Correlation coefficient = 0.766). CONCLUSION: The present results indicate the angiogenesis may play an important role in the pathogenesis and the unique clinical behavior of OKC.

X-linked hypophosphatemia: dental and histologic findings.

The recurrent spontaneous formation of abscesses affecting multiple noncarious primary as well as permanent teeth is the principle clinical dental feature in cases of hypophosphatemia, a condition inherited through the X chromosome. Patients often have high pulp horns, large pulp chambers and dentinal clefts. We report a case of hypophosphatemic vitamin D-resistant rickets in a patient who reported to our department on multiple occasions with spontaneous abscesses in relation to his primary teeth. The aim of this article is to review the features of this disorder and to discuss the risks and benefits of the treatment options suggested in the literature.

Endoscopic removal of a dentigerous cyst producing unilateral maxillary sinus opacification on computed tomography.

We report the case of a 14-year-old girl who was referred to us with a 2-year history of abnormal panoramic dental x-rays. Computed tomography of the paranasal sinuses demonstrated a left unilateral maxillary sinus opacification that had been produced by an ectopic molar. The tooth was removed via an endoscopic approach rather than with a traditional Caldwell-Luc procedure. A nasal endoscope was used to create a middle meatal antrostomy and deliver the tooth and its cystic contents. The patient recovered without complications, and she exhibited no signs of recurrence at the 2-year follow-up.

Marsupialização de cisto dentígero após traumatismo / Marsupialization of dentigerous cyst after traumatism

Objetivo: as causas mais comuns das alterações na dentição permanente são os traumatismos alvéolo-dentários (TAD) na dentição decídua, ultrapassando, inclusive, as incidências de cárie ou doença periodontal. Estes podem levar a hipoplasia de esmalte, alterações na morfologia dentária e desenvolvimento de cistos, como o cisto dentígero, considerando ainda que o tratamento desta ocorrência diverge ao tratar da dentição decídua e não da permanente. O objetivo deste trabalho é ilustrar essas características e como elas podem ser manejadas através de um relato de caso. Relato de caso: no caso em questão, ocorreu o desenvolvimento de um cisto dentígero de grandes dimensões após traumatismo alvéolo-dentário em dentição decídua na região anterior da maxila com retenção de três dentes permanentes. Foram discutidas as formas terapêuticas para tal situação clínica, bem como a possibilidade de uma abordagem multidisciplinar da cirurgia-ortodontia. Considerações finais: os TADs na dentição decídua devem ser bem diagnosticados e tratados, visando a prevenção de sequelas na dentição permanente.(AU)

Objective: the most common causes of changes in permanent dentition are alveolar-dental trauma (TAD) in deciduous dentition, with occurrence rates even higher than decays or periodontal disease, which can lead to enamel hypoplasia, changes in dental morphology and the development of cysts such as the dentigerous cyst, considering treatment differs when dealing with deciduous dentition instead of permanent dentition. The objective of this work is to illustrate these characteristics and propose a possible treatment, through a case report. Case report: in the case at hand occurred a development of a large dentigerous cyst occurred after TAD in primary dentition, in the anterior region of the maxilla with retention of three permanent teeth, discussing the therapeutic forms for such clinical situation, as well as the possibility of a multidisciplinary approach to surgery-orthodontics. Final considerations: TAD in deciduous teeth should be well diagnosed and treated aiming to prevent sequelae in permanent dentition.(AU)

Kissing molars: report of three cases and new prospective on aetiopathogenetic theories.

Kissing molars (KMs) is an extremely rare condition of impacted third molars, pointed in the opposite direction in a single follicular space; it consists exactly in a full impacted of permanent molars which occurs only in the lower jaw. Actually, about less than thirty cases have been reported in scientific literatures. The aetiology and pathogenesis of this pathological double dental inclusion remain unknown; above all events that lead two molars to appear, as KMs remain mysterious. The association to metabolic connective diseases such as mucopolysaccharidosis was emphasized. KMs considered as an isolated event, may be associated to an abnormal position of the tooth-bud from lower permanent molars, or fourth supernumerary tooth (distomolar). Recently, hyperplastic dental follicle (HDF), with a down regulation of matrix metal-proteinases and up regulation of several genes of collagens, has been mentioned in association with KMs. In this paper, after having analyzed three new cases of KMs that have been treated, we report a new hypothesis. This last is based on the failure in the dental follicle's ability to initiate or continue properly resorption of the overlying alveolar bone, by many exogenous factors which may act on eruptive phase that would lead to its rotation with its contents coming out a pathological situation of KMs. The therapy of choice is related to the surgical removal of KMs through a double odontectomy with transalveolar method. Other treatments can be, eventually, orthodontic therapy of the impacted teeth and a radiological follow-up without surgery.