Abordagens cirúrgicas para cisto dentígero: revisão de literatura / Surgical approaches for dentigerous cyst: literature review

O objetivo desta revisão integrativa foi elaborar uma avaliação qualitativa da literatura existente sobre as modalidades de tratamento utilizadas para cistos dentígeros em pacientes pediátricos. O presente estudo trata-se de uma revisão integrativa da literatura na qual utilizou-se as bases de dados PubMed, BVS (Biblioteca Virtual em Saúde), LILACS, e SciELO. Como critérios de inclusão estavam os artigos publicados na íntegra, relatos de caso clínico, revisões sistemáticas e de meta-análise publicados nos últimos 10 anos, disponível nos idiomas português ou inglês, que abordassem a temática. Os critérios de exclusão foram: resumos, anais, editoriais, cartas ao editor, reflexão, duplicidade, artigos com detalhamento incompleto. O cisto dentígero é o tipo mais comum dos cistos odontogênicos de desenvolvimento e o segundo mais frequente entre todos que ocorrem nos maxilares, representando cerca de 20% de todos os cistos revestidos por epitélio nos ossos gnáticos. Clinicamente pode estar associado a qualquer dente impactado, porém ele envolve com mais frequência os terceiros molares inferiores. Acomete pacientes entre 10 a 30 anos de idade, com predileção pelo sexo masculino, sendo na maioria dos casos detectados em exames radiográficos de rotina. O tratamento baseia-se nas técnicas de descompressão, marsupialização e enucleação. O prognóstico para os cistos dentígeros é altamente favorável e não há chance de recorrência após a remoção completa. Assim, a decisão terapêutica deve ser tomada de forma adequada para cada caso, levando em consideração a localização anatômica, extensão clínica, tamanho, idade, remoção do dente não irrompido e possibilidades de acompanhamento.

The aim of this integrative review was to carry out a qualitative assessment of the existing literature on the treatment modalities used for dentigerous cysts in pediatric patients. This study is an integrative literature review using the PubMed, VHL (Virtual Health Library), LILACS and SciELO databases. The inclusion criteria were articles published in full, clinical case reports, systematic reviews and meta-analysis published in the last 10 years, available in Portuguese or English, which addressed the subject. The exclusion criteria were: abstracts, annals, editorials, letters to the editor, reflection, duplication, articles with incomplete details. The dentigerous cyst is the most common type of developmental odontogenic cyst and the second most frequent of all those that occur in the jaws, accounting for around 20% of all epithelium-lined cysts in the gnathic bones. Clinically, it can be associated with any impacted tooth, but it most often involves the lower third molars. It affects patients between 10 and 30 years of age, with a predilection for males, and in most cases it is detected during routine radiographic examinations. Treatment is based on decompression, marsupialization and enucleation. The prognosis for dentigerous cysts is highly favorable and there is no chance of recurrence after complete removal. Therefore, the therapeutic decision must be made appropriately for each case, taking into account the anatomical location, clinical extension, size, age, removal of the unerupted tooth and follow-up possibilities.

Tratamento de odontoma composto e cisto dentígero: relato de caso / Treatment of compound odontoma and dentigeral cyst: case report

Introdução: o odontoma é considerado como um frequente tumor odontogênico benigno, podendo ser classificado em tipo composto ou tipo complexo. O cisto dentígero é o mais comum entre os cistos odontogênicos de desenvolvimento, onde envolve a coroa da unidade dentária no nível da junção amelocementária. Há poucos estudos na literatura do encontro das duas lesões, acometendo o mesmo local na cavidade oral. O diagnóstico pode ser constituído por exame clínico e de imagem. Objetivo: apresentar um caso clínico de odontoma composto e cisto dentígero em região de parassínfise mandibular esquerda abordando as caraterísticas clínicas destas duas lesões e as adequadas formas de tratamento. Relato de caso: paciente do sexo masculino, 16 anos de idade, compareceu ao ambulatório do Centro Odontológico da Escola Bahiana de Medicina e Saúde Pública (Salvador, Bahia), portando encaminhamento de ortodontista, solicitando exodontia da unidade dentária 33 inclusa associada a um odontoma. Ao realizar exames físicos e imaginológicos detectou-se a hipótese diagnóstica de odontoma composto associado a unidade dentária, envolto em folículo pericoronário ou cisto dentígero. Foi realizada biópsia excisional das duas lesões e exodontia da unidade. A análise histopatológica confirmou o diagnóstico para odontoma composto associado a cisto dentígero na unidade 33. Ao acompanhamento de 03 meses, paciente apresentou neoformação óssea da região de parassínfise mandibular, mediante a análise de novos exames imaginológicos. Discussão: há poucos estudos na literatura da associação entre as duas lesões, porém relatos afirmam que o odontoma pode ser encontrado associado aos cistos odontogênicos. Por conta da falta de maiores estudos dessa associação, há escassez de recomendações terapêuticas de acordo com faixa etária e extensão do acometimento das lesões. Considerações finais: lesões comumente assintomáticas, tem o diagnóstico constituído por exame clínico e avaliação de exames de imagem(AU)

Introduction: odontoma is considered a frequent benign odontogenic tumor and can be classified as a compound or complex type. The dentigerous cyst is the most common among developmental odontogenic cysts, where it involves the crown of the dental unit at the level of the cementoenamel junction. There are few studies in the literature on the meeting of the two lesions, affecting the same site in the oral cavity. The diagnosis can be made by clinical and imaging examination. Objective: to present a clinical case of compound odontoma and dentigerous cyst in the left mandibular parasymphysis region, addressing the clinical characteristics of these two lesions and the appropriate forms of treatment. Case report: male patient, 16 years old, attended the outpatient clinic of the Centro Odontológico da Escola Bahiana de Medicina e Saúde Pública (Salvador, Bahia), having been referred by an orthodontist, requesting extraction of the included dental unit 33 associated with an odontoma. Upon physical and imaging examinations, the diagnostic hypothesis of a compound odontoma associated with a dental unit, surrounded by a pericoronal follicle or dentigerous cyst, was detected. Excisional biopsy of the two lesions and extraction of the unit were performed. The histopathological analysis confirmed the diagnosis of compound odontoma associated with dentigerous cyst in unit 33. At the 03-month follow-up, the patient presented bone neoformation in the mandibular parasymphysis region, through the analysis of new imaging exams. Discussion: there are few studies in the literature on the association between the two lesions, but reports state that odontoma can be found associated with odontogenic cysts. Due to the lack of further studies on this association, there is a lack of therapeutic recommendations according to age group and extent of lesion involvement. Final considerations: commonly asymptomatic lesions, the diagnosis consists of clinical examination and evaluation of imaging tests(AU)

Tratamiento multidisciplinario en un niño afectado por un quiste dentígero / Multidisciplinaty treatment in a child with dentigerous cyst

Se presenta el caso clínico de un paciente que a los 7 años de edad fue remitido a la Clínica Estomatológica Provincial Docente Mártires del Moncada de Santiago de Cuba por presentar un quiste dentígero y displasia fibrosa monostótica. Desde entonces, y durante casi 10 años, el paciente ha sido atendido por un equipo multidisciplinario odontopediátrico, que ha seguido su evolución y ha aplicado diferentes protocolos diagnósticos y terapéuticos; estos últimos han incluido intervenciones quirúrgicas, rehabilitaciones protésicas, quimioterapia, entre otros. Por la complejidad del caso y la poca frecuencia con que aparecen asociadas ambas entidades clínicas en la infancia, se decidió comunicar este artículo al gremio odontológico nacional y extranjero.

The case report of a seven years old child who was referred to Mártires del Moncada Provincial Teaching Stomatological Clinic in Santiago de Cuba, who had a dentigerous cyst and monostotic fibrous displasia is presented. Since then, and almost during 10 years, the patient has been assisted by a multidisciplinary odontopediatric team, which has followed his clinical course and has applied different diagnostic and therapeutic protocols, including surgical procedures, prosthetic rehabilitations, chemotherapy, among others. Due to the case complexity and the frequency with which both clinical entities are associated in childhood, it was decided to publish this work for the national anf foreing odontological community.

The dentigerous cyst: two different treatment options illustrated by two cases / Die follikuläre Zyste: zwei unterschiedliche Behandlungsmöglichkeiten, präsentiert anhand zweier Fallbeispiele

The dentigerous cyst is the second most frequent odontogenic cyst after the radicular one. Typically, dentigerous cysts are asymptomatic and are commonly diagnosed incidentally. Due to the slow, expansive growth dentigerous cysts have the potential for dislocation of adjacent structures (neighbouring teeth, canalis retromolaris), root resorptions and in an extreme case could cause jaw fractures. A histological examination represents a sine qua non, because other more alarming pathologies (odontogenic keratocyst, unicystic ameloblastoma, myxoma, primordial odontogenic tumour etc.) can exhibit clinically and radiologically a similar appearance. This brief overview aims to illustrate, by two clinical cases, the examination, the diagnosis and decision-making for either a cystostomy or a cystectomy. The surgical procedure of both techniques is presented in a step-by-step manner.

Convolutions of dentigerous cyst: An institutional experience.

OBJECTIVE: Statement of the Problem: Benign appearing dentigerous cyst (DC), also the most common developmental odontogenic cyst, shows various complications due to its pluripotent cell lining. The spectrum of diseases produced by conversion of its pluripotent cell varies from unicystic ameloblastoma, intraosseous epidermoid and central mucoepidermoid carcinoma. So, the need of the hour is to be acquainted with the etiopathogenesis of DC at molecular level and an attempt should be made to minimize its rate of tumor conversion. PURPOSE: To analyze the potential complications, their demographic profile, disease characteristics which can arise from the dentigerous cyst, and to be geared up for such situations in future. MATERIALS AND METHOD: Retrospective analysis was conducted and data was collected from the requisition forms during the time frame 2011- 2016 in the Department at Government Dental College, Haryana. Histopathologically diagnosed cases of dentigerous cyst were reviewed by three different observers and recorded, out of which DCs that showed potential complications were reviewed in detail. RESULTS: Six cases of DC out of 26 showed transformation into central mucoepidermoid carcinoma, adenomatoid odontogenic tumor (two) and ameloblastoma (three) respectively. CONCLUSION: The present research highlights the probable complications of DC encountered in our institute and conscientious vigilance should be exercised while histopathological examination of biopsied specimens. This study further unravels the enigma behind the emergence of neoplasms arising from DC.

Cisto dentígero: diagnóstico e tratamento / Cisto dentígero: diagnosis and treatment / Cisto dentígero: diagnóstico y tratamiento

O cisto dentígero é um cisto odontogênico que é classificado como de desenvolvimento. Normalmente, está relacionado à coroa de um dente incluso, sendo um dos cistos odontogênicos mais frequentes nos ossos gnáticos. Na maioria das vezes é diagnosticado em pacientes entre a segunda e a terceira década de vida, com grande ocorrência em terceiros molares inferiores e caninos superiores. Clinicamente, apresenta evolução lenta, assintomática e pode causar discreta deformidade facial, deslocamento de dentes e alterações de estruturas na região. Radiograficamente, os cistos dentígeros são descritos como lesões radiolúcidas bem delimitadas e uniloculares. Na maioria dos casos, são observados em exames de rotina ou durante a pesquisa da causa da não erupção de um dente permanente. Apesar da singularidade clínica de cada caso, o prognóstico dessa lesão é favorável. O tratamento para o cisto dentígero pode ser a marsupialização em casos de lesões grandes, enucleação com exodontia do dente incluso ou preservação do elemento dental. Este trabalho visa apresentar um caso clínico de cisto dentígero em região posterior de mandíbula, abordando aspectos clínicos, imaginológicos, histopatológicos e terapêuticos, com a finalidade de familiarizar o cirurgião dentista com tal lesão(AU)

The dentigerous cyst is an odontogenic cyst that is classified as developmental cyst. It is usually related to the crown of an included tooth, being one of the most frequent odontogenic cysts in the gnatic bones. Most of the time it is diagnosed in patients between the second and third decade of life, with great occurrence in third molars and upper canines. Clinically, it presents slow evolution, asymptomatic and can cause discreet facial deformity, tooth dislocation and alterations of structures in the region. Radiographically, dentigerous cysts are described as well delimited and unilocular radiolucent lesions. Normally, they are seen in routine examinations or during the investigation of the cause of non-eruption of a permanent tooth. Despite the clinical singularity of each case, the prognosis of this lesion is favorable. The treatment for dentigerous cyst may be marsupialization in cases of large lesions, enucleation with exodontia of the included tooth or preservation of the dental element. This paper aims to present a case report of a dentigerous cyst in the mandible, posterior region, addressing clinical, imaging, histopathological and therapeutic aspects, in order to familiarize the dentist surgeon with such lesion(AU)

El quiste dentígero es un quiste odontogénico que se clasifica como de desarrollo. Normalmente, esta relacionada con la corona de un diente incluido, siendo uno de los quistes odontogénicos más frecuentes en los huesos gnáticos. La mayoría de las veces se diagnostica en pacientes entre la segunda y la tercera década de vida, con gran ocurrencia en terceros molares inferiores y caninos superiores. Clínicamente, presenta evolución lenta, asintomática y puede causar discreta deformidad facial, desplazamiento de dientes y cambios de estructuras en la región. Los cistos dentígeros se describen como lesiones radiolúcidas bien delimitadas y uniloculares. Normalmente, se observan en exámenes de rutina o durante la investigación de la causa de la no erupción de un diente permanente. A pesar de la singularidad clínica de cada caso, el pronóstico de esta lesión es favorable. El tratamiento para el quiste dentígero puede ser la marsupialización en casos de lesiones grandes, enucleación con exodoncia del diente incluido o preservación del elemento dental. Este trabajo pretende presentar un relato de caso clínico de quiste dentígero en mandíbula, región posterior, abordando aspectos clínicos, imaginológicos, histopatológicos y terapéuticos, con la finalidad de familiarizar al cirujano dentista con tal lesión(AU)

Conservative management of large mandibular dentigerous cysts with a novel approach for follow up: Two case reports.

BACKGROUND: Dentigerous cysts are odontogenic cysts of the jaws accounting for approximately 24% of all epithelium-lined jaw cysts. Rarely, these cysts can become extremely large causing additional symptoms, while challenging treatment. This article represents a novel approach for radiological treatment follow up of large dentigerous cysts. MATERIAL AND METHODS: Dentigerous cysts were treated by marsupialization, using dedicated obturators and enucleation of the cyst afterwards. Teeth vitality in the lesion was regularly assessed by laser doppler flowmetry, follow-up of lesion regression was accomplished using semi-automatic radiographic analysis of bone healing quantification. RESULTS: Cystic marsupialization by means of the obturator resulted in a number of advantages compared to a conventional approach: lower risk of spontaneous fracture of the mandible, anatomical structure preservation, mandibular canal identification and preservation of tooth vitality as measured by intraoral laser doppler flowmetry. Notwithstanding that a 1-year follow-up panoramic image could not visualize a remnant bone defect nor cystic lesion recurrence, 3D-CBCT based semi-automated bone quantification could only demonstrate an increase of 46% of mineralized bone volume one year after surgery. Bone healing typically occurred starting from the periphery of the original lesion towards the inner core. CONCLUSIONS: The presently reported cystic marsupialization was useful as a preliminary treatment for subsequent enucleation. 3-D CBCT based objective quantification of the bone volume and healing can provide new insights in lesion healing in general and more particular in the outcome of specific diagnostic and therapeutic challenges.

Eruption cysts: A series of 66 cases with clinical features.

BACKGROUND: An eruption cyst (EC) is a benign, developmental cyst associated with a primary or permanent tooth. This paper presents 66 ECs in 53 patients who reported to 3 different centers in Turkey between 2014-2015. MATERIAL AND METHODS: 53 patients (31 male, 22 female) with 66 ECs were diagnosed and treated over a 1-year period. The mean age of patients was 5.4 years (minimum 5 months, maximum 11 years). Clinical examination and periapical radiographs were used to establish diagnosis. Age, gender, site, history of trauma and type of treatment were recorded. RESULTS: Of the 66 ECs diagnosed in 53 patients, more than half (56.6%) were located in the maxilla, with the maxillary first primary molars the teeth most commonly associated with ECs (30.3%). Multiple ECs were diagnosed in 13 of the 53 patients. ECs had previously diagnosed in the primary dentition of 2 patients, 3 patients reported a history of trauma to primary teeth. In the majority of patients (46 cases, 86.8%), no treatment was provided, whereas surgical treatment was provided in the remaining 7 cases (13.2%). CONCLUSIONS: Eruption cysts are usually asymptomatic and do not require treatment;. however, if the cyst is symptomatic, it should be treated with simple surgical excision.

Quiste dentígero: Reporte de un caso / Dentigerous cyst: A case report

Los quistes del maxilar constituyen un conjunto muy variado de entidades, entre las que se incluyen los tumores benignos y malignos de origen odontogénico. Existe poca información sobre la prevalencia de esta patología. Afecta con mayor frecuencia al sexo masculino, entre la segunda y la tercera década de la vida. La proporción de pacientes de 6 a 7 años con quistes dentígeros es de solo 9,1%. El quiste dentígero engloba la corona de un diente permanente normal, impactado, no erupcionado. Suele presentar una sintomatología insidiosa y no se descubre hasta que la tumoración afecta a los órganos vecinos. El objetivo es exponer un caso de quiste dentígero. Si bien es de aparición muy poco frecuente, la presentación de este caso sirve para poner al médico pediatra en conocimiento sobre cómo debe actuar ante una tumoración maxilar unilateral en un niño sano. Se remarca la importancia del manejo multidisciplinario de la entidad.

Maxillary cysts are a diverse group of entities that include benign and malignant odontogenic tumors. Information on the prevalence of this disease is limited. It is more common among males, and usually occurs in the second and third decade of life. The proportion of 6 to 7 year old patients with dentigerous cysts is only 9.1%. Dentigerous cysts encompass the crown of a permanent and unerupted impacted teeth. They are usually slow growing asymptomatic lesions that are not discovered until they affect surrounding organs. The aim of this study is to present an unusual case of dentigerous cyst and to inform the pediatrician about the management of a unilateral maxillary tumor in a healthy child, underlining the importance of a multidisciplinary approach of this disease.

[Dentigerous cyst: a case report]. / Quiste dentígero: reporte de un caso.

Maxillary cysts are a diverse group of entities that include benign and malignant odontogenic tumors. Information on the prevalence of this disease is limited. It is more common among males, and usually occurs in the second and third decade of life. The proportion of 6 to 7 year old patients with dentigerous cysts is only 9.1%. Dentigerous cysts encompass the crown of a permanent and unerupted impacted teeth. They are usually slow growing asymptomatic lesions that are not discovered until they affect surrounding organs. The aim of this study is to present an unusual case of dentigerous cyst and to inform the pediatrician about the management of a unilateral maxillary tumor in a healthy child, underlining the importance of a multidisciplinary approach of this disease.

Los quistes del maxilar constituyen un conjunto muy variado de entidades, entre las que se incluyen los tumores benignos y malignos de origen odontogénico. Existe poca información sobre la prevalencia de esta patología. Afecta con mayor frecuencia al sexo masculino, entre la segunda y la tercera década de la vida. La proporción de pacientes de 6 a 7 años con quistes dentígeros es de solo 9,1%. El quiste dentígero engloba la corona de un diente permanente normal, impactado, no erupcionado. Suele presentar una sintomatología insidiosa y no se descubre hasta que la tumoración afecta a los órganos vecinos. El objetivo es exponer un caso de quiste dentígero. Si bien es de aparición muy poco frecuente, la presentación de este caso sirve para poner al médico pediatra en conocimiento sobre cómo debe actuar ante una tumoración maxilar unilateral en un niño sano. Se remarca la importancia del manejo multidisciplinario de la entidad.

Aproveitamento de dente retido associado ao cisto dentígero após marsupialização: série de casos / Recover impacted tooth associated with dentigerous cyst after marsupialization: series cases

O cisto dentígero é uma entidade patológica comum associada a um dente impactado. O tratamento preconizado para esta lesão é a sua enucleação com remoção do dente envolvido. Recentemente, tem sido defendida a marsupialização da lesão, uma vez que, em alguns casos, possibilita o aproveitamento do dente impactado. O objetivo deste trabalho foi apresentar uma série de casos de aproveitamento de dentes retidos associados a cisto dentígero, empregando-se a marsupialização. Para isso, realizou-se um estudo epidemiológico transversal, fundamentado na análise retrospectiva e descritiva dos livros de registro do Serviço de Estomatologia e Cirurgia Bucomaxilofacial do Hospital Municipal Odilon Behrens (HMOB) no período de Novembro de 2005 a Novembro de 2015. Os resultados mostraram doze pacientes que receberam a marsupialização como tratamento do cisto dentígero, em que a média de idade foi nove anos, sendo oito homens (66,7%) e quatro mulheres (33,3%). Os dentes mais envolvidos foram pré-molares e incisivos centrais superiores e o tempo médio de erupção foi de 13 meses, sendo que a maioria das erupções ocorreram de forma espontânea. Em todos os casos verificou-se erupção do dente associado e neoformação óssea na região onde havia o cisto. Não foram observadas recidivas. Sendo assim, pode-se concluir que a marsupialização é uma opção terapêutica eficiente na abordagem de pacientes jovens portadores de cistos dentígeros

The dentigerous cyst is a common pathological condition associated with an impacted tooth. The recommended treatment for this injury is its enucleation with removal of the involved tooth. Recently, it has been advocated Marsupialization injury, since in some cases, allows the use of impacted teeth. The objective of this study was to present a series of cases of impacted teeth associated with dentigerous cyst, using marsupialization. For this, we performed a cross-sectional epidemiological study, based on retrospective and descriptive analysis of the record books of the Serviço de Estomatologia and Bucomaxilofacial at the Hospital Municipal Odilon Behrens (HMOB) in November 2005 to November 2015. The results showed twelve patients receiving marsupialization as a treatment for dentigerous cyst, where the average age was nine years, eight men (66.7%) and four women (33.3%). The most involved teeth were premolars and maxillary central incisors and the average time of rash was 13 months, with most eruptions occurred spontaneously. In all cases it was associated with the eruption of the tooth and in the region where bone formation was the cyst. Recurrences were observed. Thus, it can be concluded that the marsupialization is an effective approach to therapeutic option in young patients with Dentigerous Cysts

Autotransplantation of an impacted premolar using collagen sponge after cyst enucleation.

INTRODUCTION: We report a case of successful autotransplantation of a premolar impacted with a dentigerous cyst and transplanted with collagen plugs for initial support. METHODS: An 18-year-old man had an impacted premolar accompanied with a large dentigerous cyst. The tooth was extracted surgically and transplanted to an edentulous alveolar ridge, and a collagen sponge was inserted to ensure proper healing and initial support. Root canal treatment was performed 3 weeks after the surgery. RESULTS: The previous lesion was healed, and the transplanted tooth was functional without any pathologic signs. CONCLUSIONS: Our protocol provides a viable option for saving an impacted tooth in the case of cyst enucleation.

Dentigerous cyst of inflammatory origin.

There is an association between persistent, prolonged inflammation of a primary tooth and the development of an inflammatory dentigerous cyst involving the succedaneous tooth. The purpose of this case report is to describe the management of an inflammatory dentigerous cyst of the permanent maxillary left central incisor in a nine-year-old boy caused by a long-term inflammation/infection of its predecessor. The treatment consisted of conservative decompression, which allowed for rapid healing and the eruption of the permanent tooth. The patient was followed up with periodic clinical and radiographic evaluations for several years.

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.

Quiste dentígero de gran tamaño que ocupa el seno maxilar y desplaza a tercer y cuarto molares ectópicos a fosa cigomática / Large dentigerous cyst in the maxillary sinus with displacing ectopic third and fourth molars into zygomatic fossa

Presentar un caso de quiste dentígero que invade el seno maxilar asociado a un tercer y cuarto molares ectópicos. Caso clínico: se presenta un caso de quiste dentígero de gran tamaño que invade el seno maxilar en su totalidad, asociado a tercer y cuarto molares, en una paciente de sexo femenino de 14 años. Se realizó la exéresis completa de la lesión mediante un abordaje de Cadwell-Luc. Conclusión: es de suma importancia el diagnóstico temprano de estas patologías a través de un correcto examen clínico y radiológico. En quistes de gran tamaño y de evlución rápida, como es el caso presentado, debemos considerar la posibilidad de una transformación ameloblástica o carcinomatosa en la pared quística. Por esta razón, tendremos que elegir un tratamiento que nos asegurela extirpación total de la lesión y su posterior análisis histopatológico para determinar la conducta por seguir.

Quiste dentígero de gran tamaño que ocupa el seno maxilar y desplaza a tercer y cuarto molares ectópicos a fosa cigomática / Large dentigerous cyst in the maxillary sinus with displacing ectopic third and fourth molars into zygomatic fossa

Presentar un caso de quiste dentígero que invade el seno maxilar asociado a un tercer y cuarto molares ectópicos. Caso clínico: se presenta un caso de quiste dentígero de gran tamaño que invade el seno maxilar en su totalidad, asociado a tercer y cuarto molares, en una paciente de sexo femenino de 14 años. Se realizó la exéresis completa de la lesión mediante un abordaje de Cadwell-Luc. Conclusión: es de suma importancia el diagnóstico temprano de estas patologías a través de un correcto examen clínico y radiológico. En quistes de gran tamaño y de evlución rápida, como es el caso presentado, debemos considerar la posibilidad de una transformación ameloblástica o carcinomatosa en la pared quística. Por esta razón, tendremos que elegir un tratamiento que nos asegurela extirpación total de la lesión y su posterior análisis histopatológico para determinar la conducta por seguir. (AU)

[Dentigerous cyst associated with maxillary canine as a reason of occlusion defect - case report of 7-year old boy]. / Torbiel zawiazkowa kla górnegojako przyczyna zaburzen zgryzu-opis przypadku 7-letniego chlopca.

Dentigerous cysts are characterized by slow and non-symptomatic growth. Usually they are recognized accidentally during the radiological examination of patients with an occlusion defect or dental age different than growing age. In the case described, the patient presented for dental treatment with the complaint of an occlusion defect and the appearance of a right deciduous maxillary lateral incisor (52). Radiological examination showed the presence of a horizontally positioned maxilla right lateral incisor (12) and dentigerous cyst of tooth 13 (right canine) in the maxilla sinus. After surgical consultation the cyst enucleation and extraction of the unerupted maxillary right canine were performed. Four months later the orthodontic treatment began.

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.

Cystic lesions of the jaws - a clinicopathological study of 322 cases and review of the literature.

Three hundred and twenty-two patients (192 male and 130 female) with cystic lesions of the jaw were successfully diagnosed and treated. One hundred and fifty-five (48%) were radicular cysts, 80 (25%) were dentigerous cysts, 23 (7%) were odontogenic keratocyst (=keratocystic odontogenic tumor), 19 (6%) were eruption cysts, 16 (5%) were traumatic bone cysts, and 29 (9%) were non-odontogenic cysts. There were 95 in the pediatric age group (1 month to 16 years) and 227 in the adult age group (17 years and older). Male to female ratio was 1 in the pediatric age group and 1.7 in the adult age group. The treatment modalities were: marsupialization, enucleation, enucleation with bone grafting, or resection. The distribution and characteristics of jaw cysts in children are different from those in adults. In children there is a relatively high rate of developmental cysts, whereas in adults the inflammatory cysts are more common. Following enucleation of a cystic jaw lesion, the entire surgical specimen and not only a biopsy specimen, should be examined histopathologically to prevent any possibility of an intramural squamous cell carcinoma that may be overlooked. The differences in prevalence of each type of jaw cyst during a lifetime may point toward a multifactorial polygenic pattern rather than a monogenic pattern.