Life threatening hemorrhage associated with a dentigerous cyst in a dog: Case report.

Dentigerous cysts are the most common type of odontogenic cysts and arise from an unerupted tooth. These cysts have stereotypical radiographic and clinical findings. They can be extremely invasive but rarely present as a life-threatening emergency. This case report describes the stabilization and treatment of a 6-year-old mixed breed dog with a dentigerous cyst with concurrent life-threatening hemorrhage. The dog presented with severe oral hemorrhage from the mandibular artery and required multiple blood transfusions. It was ultimately diagnosed with a dentigerous cyst. Complications from dental issues and potential life-threatening complications, such as this case, can be prevented by routine annual oral examination and full mouth dental radiographs if an unerupted tooth is suspected.

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)

Pediatric Oral Pathology: Odontogenic Cysts.

Cysts encountered in the head and neck typically arise from epithelium that would normally be programmed to form teeth or tooth-supporting structures (odontogenic epithelium). These cysts come with a confusing array of similar-sounding names and histopathologic features that are sometimes shared between conditions. Here we describe and contrast the relatively-common lesions: hyperplastic dental follicle, dentigerous cyst, radicular cyst, buccal bifurcation cyst, odontogenic keratocyst, glandular odontogenic cyst, and the less-common gingival cyst of the new-born and thyroglossal duct cyst. The goal of this review is to help clarify and simplify these lesions for the general pathologist, pediatric pathologist, and surgeon.

Diagnóstico e tratamento de extenso cisto dentígero mandibular em um paciente pediátrico / Diagnosis and treatment of extensive mandibular dentigerous cyst in a pediatric patient

Introdução: lesões gnáticas pediátricas são comumente assintomáticas e diagnosticadas em exames de imagem de rotina. Entretanto, algumas podem cursar com dor, assimetria facial, destruição óssea e rápida evolução, requerendo diagnóstico preciso e precoce. Objetivo: o objetivo desse estudo é reportar o processo de diagnóstico e tratamento de um extenso cisto dentígero (CD) em um paciente pediátrico. Relato do caso: um menino de 5 anos idade apresentou queixa de aumento de volume doloroso na região posterior de mandíbula com tempo de evolução de 4 meses. A tomografia computadorizada demonstrou uma imagem hipodensa, bem delimitada, envolvendo a coroa do dente 37, causando a expansão da cortical vestibular e erosão da cortical lingual, com aproximadamente 3cm. Com as hipóteses diagnósticas de fibroma ameloblástico ou CD, a lesão foi enucleada totalmente. Microscopicamente, observou-se uma lesão cística com revestimento epitelial odontogênico, áreas de hiperplasia e exocitose, além de cápsula de tecido conjuntivo densamente colagenizado, com áreas de hemorragia e infiltrado inflamatório linfoplasmocitário. Resultados: baseado nas características clínicas, imagenológicas e histopatológicas, o diagnóstico final foi de CD inflamado. O paciente continua em acompanhamento clínico e radiográfico, com ausência de recidiva. Conclusão: CD inflamados em pacientes pediátricos podem apresentar comportamento peculiar e mimetizar outras lesões de natureza odontogênica. O diagnóstico precoce permite uma menor morbidade associada aos tratamentos cirúrgicos.

Introduction: pediatric gnathic lesions are commonly asymptomatic and diagnosed in routine imaging exams. However, some of them may cause pain, facial asymmetry, bone destruction and rapid evolution, requiring accurate and early diagnosis. Objective: the aim of this study is to report the diagnosis and treatment of an extensive dentigerous cyst (DC) in a pediatric patient. Case report: a 5-year-old boy complained of painful swelling in the posterior region of the mandible with an evolution time of 4 months. Computed tomography showed a hypodense, well-delimited image involving the crown of tooth 37, causing buccal cortical expansion and lingual cortical erosion, measuring approximately 3cm. With the diagnostic hypotheses of ameloblastic fibroma or DC, the lesion was completely enucleated. Microscopically, a cystic lesion with an odontogenic epithelial lining with areas of hyperplasia and exocytosis was observed, in addition to a densely collagenous connective tissue capsule, with areas of hemorrhage and lymphoplasmacytic inflammatory infiltrate. Results: based on clinical, imaging and histopathological characteristics, the final diagnosis was inflamed DC. The patient remains under clinical and radiographic follow-up, with no recurrence. Conclusion: inflamed DC in pediatric patients may show a peculiar behavior and mimic other odontogenic lesions. Early diagnosis allows for lower morbidity associated with surgical treatments.

Enucleación de quiste dentígero, asociado al incisivo lateral retenido, y tracción ortodóntica de canino superior retenido / Enucleation of tooth cyst, associated with retained lateral incisor, and orthodontic traction of retained upper canine

Introducción: Un inconveniente de la erupción dental permanente es la retención dentaria. Un diente retenido no ha completado su erupción y no ha llegado a su posición normal en el maxilar. Los dientes retenidos pueden estar dentro del maxilar asintomáticos u ocasionando migración dentaria, persistencia de dientes deciduos, alteraciones en la oclusión y estética, formación de quiste dentígero y tumores. Objetivo: Describir la enucleación de quiste dentígero, asociado al incisivo lateral, y tracción ortodóntica de canino superior retenido. Presentación de caso: Paciente femenino de 19 años de edad, con persistencia de dientes 52 y 53. Tomográficamente se aprecia un incisivo lateral superior derecho retenido en posición horizontal, asociado a una imagen radiolúcida de dimensiones de 11,2 mm x 20,1 mm y un canino retenido en posición vertical. Se realizó la exodoncia a colgajo del incisivo lateral y enucleación del quiste. Respecto al canino, se colocó el botón de ortodoncia para posterior tracción. El diagnóstico histopatológico definitivo fue quiste dentígero. Conclusiones: Las lesiones asociadas a dientes retenidos pueden tener varios diagnósticos diferenciales. El especialista deberá conocer las características clínicas y radiográficas de cada uno de ellos y proyectar el plan de tratamiento de acuerdo a los criterios de ubicación, tamaño de la lesión, edad, estado sistémico, entre otros. El conocimiento de la técnica quirúrgica y el diagnóstico histopatológico evita complicaciones(AU)

Introduction: A drawback of permanent tooth eruption is tooth retention. A retained tooth has not completed its eruption and has not reached its normal position in the jaw. Retained teeth may be within the jaw asymptomatic or causing tooth migration, persistence of deciduous teeth, alterations in occlusion and aesthetics, formation of tooth cyst and tumors. Objective: Describe the enucleation of dentiger cyst, associated with the lateral incisor, and orthodontic traction of retained upper canine. Case presentation: Female patient, 19 years old, with persistence of teeth 52 and 53. Tomographically there is a right upper lateral incisor retained in a horizontal position, associated with a radiolucent image of dimensions of 11.2 mm x 20.1 mm and a canine retained in an upright position. Exodontics were performed at the flap of the lateral incisor and enucleation of the cyst. Regarding the canine, the orthodontic button was placed for subsequent traction. The definitive histopathological diagnosis was tooth cyst. Conclusions: Lesions associated with retained teeth may have several differential diagnoses. The specialist must know the clinical and radiographic characteristics of each of them and project the treatment plan according to the criteria of location, size of the lesion, age, systemic status, among others. Knowledge of surgical technique and histopathological diagnosis avoids complications(AU)

Ocorrência simultânea de cisto dentígero e odontoma composto-complexo causando impacção dentária / Simultaneous occurrence of dentigerous cyst and compound-complex odontoma causing dental impaction

O presente trabalho ilustra e discute essa doença que representa o tumor odontogênico mais comum da prática clínica, o Odontoma. Para tal, apresenta um caso clínico com imagens clínicas e radiográficas esclarecedoras dos aspectos dessa doença, bem como discussão a partir de revisão narrativa de literatura direcionada para a carac-terização da doença. Relata-se o caso de um odontoma composto-complexo, uma forma incomum de odontoma, mas que mantém os demais aspectos usuais, sendo uma mulher de 21 anos com lesão radiopaca em maxila de-tectada devido à não erupção do 23. A remoção cirúrgica seguiu a partir de acesso anterior na maxila e o exame histopatológico mostrou os aspectos típicos de um Odontoma composto e complexo juntos. Independentemente da variante, nota-se que o Odontoma é quase sempre indolente, porém requer cuidados de remoção precoce devido à possibilidade de crescimento, de desenvolvimento de cistos e comprometimento de estruturas adjacentes devido a sua localização e possibilidade de crescimento (AU)

The present work illustrates and discusses this disease that represents the most common odontogenic tumor in clinical practice, the Odontoma. However, an unusual variation of the same is included here in the literature, char-acterized by the exams as a form of compound-complex odontoma additionally causing dentigerous cyst formation and dental impaction. The unusual case occurred in a 21-year-old woman, complaining of missing the tooth 23. The details of the exams allowed the visualization of compound and complex areas in the lesion, cystic formation and dental impaction. The histopathological findings confirmed the diagnosis of the Odontoma, and the interpreta-tion with the set of other exams led to the final diagnosis of Compound-complex odontoma with dentigerous cyst. The present case highlights the need for early removal of Odontoma due to the possibility of developing cysts, compromising adjacent structures, in addition to its growth potential already reported in the literature (AU)

Pediatric Odontogenic and Maxillofacial Bone Pathology: A Global Analysis.

BACKGROUND: Although pathology in the maxillary and mandibular bones is rare in young patients, the differential diagnosis is broad. The World Health Organization (WHO) updated its classification of maxillofacial bone pathology in 2017. Using these updated guidelines, a systematic review of common maxillofacial bone lesions in the pediatric population was performed. METHODS: A PubMed search was conducted capturing English language articles from inception to July 2020. Thirty-one articles were identified that described the frequency of maxillofacial bone pathology. Data were extracted and organized using the WHO 2017 classification of odontogenic and maxillofacial bone tumors. Prevalence data were analyzed among diagnostic categories and geographical regions. The SAS version 9.4 was used to complete statistical analyses. RESULTS: The articles included patients from birth to a maximum age of 14 to 19 years. The most common odontogenic cysts included radicular cyst (42.7%) and dentigerous cyst (39.0%) followed by odontogenic keratocyst (15.0%). Among odontogenic bone tumors, odontoma (49.3%) was most common followed by ameloblastoma (29.1%). The most common nonodontogenic bone tumor was fibrous dysplasia (42.4%), and the most common malignant bone tumor was osteosarcoma (75.0%). Significant variations were found by geographic region, with dentigerous cyst more common than radicular cyst, and ameloblastoma more common than odontoma in African and Asian countries (P < 0.0001). CONCLUSIONS: This systematic review uses the WHO 2017 guidelines to classify common odontogenic and nonodontogenic maxillofacial bone lesions around the world. Pathogenesis, presentation, and available treatment options for the most common maxillofacial bone lesions are reviewed.

Dentigerous cyst in a young child: a case report.

Dentigerous cysts are one of the most common developmental types of odontogenic cysts occurring in the oral cavity and often manifest as incidental findings on dental radiographs and/or as asymptomatic swellings. These cysts develop from remnants of reduced enamel epithelium around the crown of an unerupted or impacted tooth, attached at the level of the cementoenamel junction. Most are considered developmental. However, in young clients they may be inflammatory in origin, the result of caries in the primary dentition. This short communication highlights a case of an asymptomatic dentigerous cyst identified in a 4-year-old child and subsequent enucleation under general anesthesia. A thorough clinical and radiographic assessment of the oral cavity in pediatric clients merits a review of dentigerous cysts by the dental hygienist.

Les kystes dentigères sont parmi les types développementaux de kystes odontogènes les plus courants qui apparaissent dans la cavité buccale et se manifestent souvent comme des découvertes imprévues sur les radiographies dentaires ou comme des enflures asymptomatiques. Ces kystes se développent à partir de restes d'épithélium d'émail réduit autour de la couronne d'une dent incluse ou enclavée, attachés au niveau de la jonction cémento-émail. La plupart des kystes sont considérés comme développementaux. Cependant, chez les jeunes clients, ils peuvent être d'origine inflammatoire, la conséquence de caries dans la dentition primaire. Cette brève communication souligne un cas de kyste dentigère asymptomatique décelé chez un enfant de 4 ans et une énucléation subséquente sous anesthésie générale. Une évaluation clinique et radiographique approfondie de la cavité buccale des clients pédiatriques justifie que l'hygiéniste dentaire se renseigne sur les kystes dentigères.

Dentigerous cyst: enucleation or marsupialization? (a case report).

Dentigerous cysts, also called follicular cysts, are slow-growing benign odontogenic cysts that are thought to be developmental in origin. On imaging, they usually present as a well-defined and unilocular radiolucency surrounding the crown of an unerupted or impacted tooth. This article presents a case of unilateral mandibular dentigerous cysts associated with unerupted mandibular canine in a healthy patient treated by enucleation, along with a review of the literature and an examination of the treatment modality. The aim of this paper is to highlight how to choose the adequate treatment for dentigerous cyst cases.

Amblyopia due a dentigerous cyst. Case report and literature review.

PURPOSE: The goal of this article is to present an infrequent clinical case and to review the available literatura, with an emphasis on ophthalmological symptoms. METHODS: We present the case of a 4-year-old girl with a large dentigerous cyst on the maxillary bone, who had long-standing unilateral epiphora associated with progressive ocular dystopia, facial asymmetry and ipsilateral amblyopia. A multidisciplinary approach was taken by the maxillofacial surgery, ophthalmology and optometry teams. This included systemic antibiotic administration, surgical cyst drainage and amblyopia treatment. The literature review was carried out in the MEDLINE database through the free electronic access to PubMed in March 2020. RESULTS: At the 6-month follow-up, the patient was asymptomatic. The most common symptoms of dentigerous cysts are epiphora 36.8%, ocular dystopia 31.2%, diplopia 21.1%, proptosis, nasolacrimal duct obstruction and blurred vision at 10.5%. Amblyopia has not been reported. CONCLUSIONS: Dentigerous cysts are benign odontogenic cysts, which can be found in the jaw and less frequently on the maxillary bone. They are usually asymptomatic, and the occurrence of ophthalmic complications is very infrequent. Multidisciplinary management is essential to avoiding long-term morbidity of maxillary dentigerous cysts and should include an ophthalmologist.

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.

Heterotopic Polyodontia: Diagnosis and Surgical Removal of a Dentigerous Cyst Comprising 2 Dental Structures in a 14-Year-Old Horse.

A 14-year-old American Paint Horse mare was referred for further evaluation of a firm mass with an associated draining tract at the base of the left ear suspected to be a dentigerous cyst. Approximately three months prior, the draining tract had been excised under the presumed diagnosis of an abscess with no improvement. Physical examination revealed a firm mass palpable at the base of the left ear with a draining tract that did not elicit any pain response on palpation. Digital radiographs revealed a 6x11cm mineral mass in the left temporal region. Medially, there were two projections that extended into the left temporal bone. Cone beam computed tomography (CT) showed mild thinning of the temporal bone separating the mass and the brain at the conical extension of the caudal aspect of the mass. Both structures were isolated and elevated using a combination of osteotomes, mallet, and bone rongeurs under general inhalant anesthesia with radiographs to determine complete removal. Although histopathology was declined, gross examination of both structures resembled adult molar teeth. At eight months postoperative, the owners reported that the surgical site was healed and no discharge was present. Dentigerous cysts should remain a differential for a mass with an associated draining tract at the base of the ear in horses. Practitioners should strongly consider CT when feasible for additional diagnostics in similar cases. Although benign and removal poses risk, dentigerous cysts can be surgically excised with a positive outcome.

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.

Endoscopic management of a giant dentigerous cyst.

Dentigerous cyst is one of the most common developmental cyst of the jaw which accounts for approximately 20%-30% of bone cyst in the head and neck region. Most common site is the third molar of the mandible. However, maxillary involvement is not uncommon. The clinical presentation of this depends mainly on the size and anatomical compromise that occur due to compression. This case highlights the role of endoscopic approach in the management of large expansible cyst of maxilla involving the palate, thus preserving the anatomy and reducing the morbidity associated with an open procedure.

Dentigerous cyst exhibiting prominent mucous cell metaplasia: report of a unique case mimicking central mucoepidermoid carcinoma.

A Japanese male aged 61 presented with persistent pain in the left posterior area of the mandible for several weeks. A panoramic X-ray revealed a unilocular lesion showing characteristics of a dentigerous cyst associated with an impacted third molar. A cystectomy was performed and histopathological examination revealed a cystic lesion with a fibrous wall. The lumen was covered with non-keratinizing squamous cells with obvious intercellular bridges, which were intermingled with partially ciliated goblet-cell-type mucous and columnar cells. Such cystic lesions should be carefully examined to distinguish them from the glandular odontogenic cyst and central mucoepidermoid carcinoma of the jawbone.

Voluminoso quiste dentígero de mandíbula tratado en dos etapas quirúrgicas informe de caso / Volumoso cisto dentígero de mandíbula tratado em duas etapas cirurgicas - relato de caso / Large dentigerous mandibular cyst treated in two surgical steps. A case report

Resumen El quiste dentígero es una lesión benigna que se origina en el epitelio odontogénico asociado a la corona de un diente incluido. Son radiolúcidos y uniloculares, generalmente asintomáticos y diagnosticados en exámenes de rutina o exámenes radiográficos. Los terceros molares inferiores y los caninos superiores son los dientes más afectados, y esta lesión también ocurre en dientes supernumerarios o asociados a odontomas. De crecimiento lento puede alcanzar dimensiones considerables, provocando deformidad facial, impactación y desplazamiento de dientes y/o estructuras adyacentes. El objetivo de este trabajo es informar un caso clínico de un voluminoso quiste dentígero mandibular, que se trató quirúrgicamente en dos etapas: la primera intervención con fines de biopsia y descompresión de la lesión y la segunda con el objetivo de enuclear la cápsula remanente. De esta forma, fue posible realizar un diagnóstico preciso de la lesión, reducir su tamaño para permitir una enucleación total con un daño mínimo a las estructuras anatómicas circundantes y la preservación de la función neurosensorial. Se realizó el seguimiento del paciente durante un período de 5 años en el posoperatorio, y el caso evolucionó hasta la curación total.

Resumo O cisto dentígero é uma lesão benigna oriunda do epitélio odontogênico associado à coroa de um dente incluso. São radiolúcidos e uniloculares, normalmente assintomáticos e diagnosticados em exames de rotina ou exame radiográfico. Os terceiros molares inferiores e os caninos superiores são os dentes mais acometidos, tendo também ocorrência desta lesão em dentes supranumerários ou associados a odontomas. De crescimento lento pode atingir dimensões consideráveis, causando deformidade facial, impactação e deslocamento de dentes e/ou estruturas adjacentes. O objetivo deste trabalho é relatar um caso clínico de volumoso cisto dentígero mandibular, tratado cirurgicamente em duas etapas: a primeira intervenção com fins de biópsia e descompressão da lesão e uma segunda com intuito de enuclear a capsula rôta. Desta forma pôde-se realizar o diagnostico preciso da lesão, diminuir seu tamanho de forma a permitir a enucleação total com o mínimo de dano as estruturas anatômicas circunvizinhas e a preservação da função neurossensorial. O paciente foi acompanhado por um período de 05 anos no pós operatório, tendo o caso evoluído para a cura total.

Abstract A dentigerous cyst is a benign lesion arising from the odontogenic epithelium associated with the crown of an impacted tooth. They are radiolucent and unilocular, usually asymptomatic and diagnosed in clinical routine or radiographic examinations. The lower third molars and upper canines are the most affected teeth, and the lesion is also associated with odontomas and supernumerary teeth. The cyst is slow-growing but can reach considerable dimensions, causing facial deformity, impaction, and displacement of teeth or adjacent structures. This study aims to report the clinical case of a large mandibular dentigerous cyst treated in two stages: biopsying and decompressing the lesion and enucleating the cyst capsule. It was thus possible to accurately diagnose the lesion, reduce its size to allow for total enucleation with minimal damage to the surrounding anatomical structures, and preserve sensitive function. A five-year follow-up was performed, with full lesion healing.

Equine heterotopic polyodontia: a case report / Poliodontia heterotópica equina: relato de caso / Poliodontia heterotópica equina: relato de caso

Heterotopic polyodontia have been described in most domestic species. Known as a dentigerous cyst but appropriately called heterotopic polyiodontics, it rarely occurs in horses, however it is easily recognized as a congenital defect. The cysts usually associated with this condition contain part or all of dental structures. The heterotopic tooth or dental structure is usually adhered to the temporal bone and surrounded by a secretory membrane, with a accumulation of exudate and draining tract along the proximal pinna or directly over the cyst. This case report describes in a 2.5-year-old female quarter horse, weighing 430 kg, with a heterotopic polyodontia that contained two easily small's identifiable dental structures, presented for evaluation of a chronic intermittent mucopurulent exudate discharge from the right sub-auricular region in the mastoid process of the temporal bone and a drainage tract near the right pinna. The diagnosis is established with clinical, radiographic, ultrasound and confirmed by histopathological examination of the structures removed. The cystic capsule was surgically removed, measuring approximately 3.0 x 2.3 cm in diameter, filled with mucopurulent exudate and containing two dental structures within 0.5 cm in diameter and 0.2 cm in diameter. Microscopic examination revealed a cystic area covered by stratified squamous epithelium with a lympho-histio-plasmatic cell infiltrate in the dermis, which was compatible with heterotopic polyodontia. Postoperatively, there were no neuromotor sequelae and wound healing evolved positively.(AU)

A poliodontia heterotópica tem sido descrita na maioria das espécies domésticas. Conhecido como cisto dentígero, mas apropriadamente denominado poliodontia heterotópica, raramente ocorre em equinos, porém é facilmente reconhecido como defeito congênito. Os cistos geralmente associados a essa condição contêm parte ou toda as estruturas dentarias. O dente heterotópico ou estrutura dentaria é comumente encontrado aderido ao osso temporal e envolvido por uma membrana secretora, com acúmulo de exsudato e trajeto de drenagem ao longo do pavilhão auricular proximal ou diretamente sobre o cisto. Este relato descreve um caso de em um equino,fêmea, quarto de milha, com 2,5 anos de idade, pesando 430 kg, com poliodontia heterotópica que continha duas estruturas dentarias facilmente indentificadas, apresentando um orifício na região sub-auricular direita no processo mastóideo do osso temporal, com secreção mucopurulenta intermitente e crônica, próximo ao pavilhão auricular direito. O diagnóstico foi estabelecido com exame clínico, radiográfico, ultrassonográfico e confirmado pelo exame histopatológico das estruturas retiradas. A cápsula cística foi removida cirurgicamente medindo aproximadamente 3,0 x 2,3 cm de diâmetro, preenchida com exsudato mucopurulento e contendo em seu interior duas estruturas dentárias medindo cerca de 0,5 cm de diâmetro e 0,2 cm de diâmetro. O exame microscópico revelou área cística revestida por epitélio escamoso estratificado com infiltrado linfo-histo-plasmocitário na derme, compatível com poliodontia heterotópica. No pós-operatório não houve sequelas neuromotoras e a cicatrização da ferida evoluiu positivamente.(AU)

La poliodontia heterotópica ha sido descrita en la mayoría de las especies domésticas. Conocido como quiste dentígero, pero apropiadamente llamado poliodontia heterotópica, raramente ocurre en equinos, sin embargo se reconoce fácilmente como un defecto congénito. Los quistes generalmente asociados a esa condición contienen parte o la totalidad de las estructuras dentales. El diente heterotópico o estructura dental se encuentra comúnmente adherido al hueso temporal y rodeado por una membrana secretora, con acumulación de exudado y vía de drenaje a lo largo del pabellón auricular proximal o directamente sobre el quiste. En este informe se describe el caso de una hembra, cuarto de milla, de 2,5 años de edad, con 430 kg de peso, presentando poliodontia heterotópica que contenía dos estructuras dentales fácilmente identificables, con un orificio en la región subauricular derecha en el proceso mastoides del hueso temporal, secreción mucopurulenta intermitente y crónica próximo al oído derecho. El diagnóstico se estableció con examen clínico, radiográfico, ecográfico y se confirmó con el examen histopatológico de las estructuras extirpadas. La cápsula quística se extrajo quirúrgicamente midiendo aproximadamente 3,0 x 2,3 cm de diámetro, rellena con exudado mucopurulento y conteniendo en su interior dos estructuras dentales que medían aproximadamente 0,5 cm de diámetro y 0,2 cm de diámetro. El examen microscópico reveló una zona quística cubierta por un epitelio escamoso estratificado con infiltrado linfo-histo-plasmocítico en la dermis, compatible con poliodontia heterotópica. En el postoperatorio no se produjeron secuelas neuromotoras y la cicatrización de la herida evolucionó positivamente.(AU)

[Odontogenic tumors and odontogenic cysts: a clinical and pathological analysis of 4 181 cases].

Objective: To investigate the incidence and constituent ratio of odontogenic tumors or odontogenic cysts in School and Hospital of Stomatology, Jilin University and to provide the reference for the clinical treatment. Methods: According to the WHO 2017 histological classification criteria, the pathological data of 4181 patients diagnosed as odontogenic tumors or odontogenic cysts in the Department of Pathology, Jilin University Stomatological Hospital from January 1961 to December 2017 were collected. Statistical analysis of the pathological types, gender, age and location of various tumors and cysts was conducted. Results: Of 4 181 cases, 1 055 were tumors and 3 126 were cysts. Among odontogenic tumors, benign tumors accounted for 96.11% (1 014/1 055), and malignant tumors accounted for 3.89% (41/1 055). The most common pathological type of odontogenic tumors was ameloblastoma [53.27% (562/1 055)], followed by cemento-ossifying fibroma [21.23% (224/1 055)] and odontoma [12.99% (137/1 055)]. The male-female ratio was 1∶1.04. The high-risk ages were 10-39. Maxilla-mandible ratio was 1∶2.85.As for cysts, radicular cysts [50.45% (1 577/3 126)] was the most common pathological type, followed by odontogenic keratocyst [25.59% (800/3 126)] and dentigerous cysts [21.56% (674/3 126)]. The male-female ratio was 1.37∶1. The high-risk ages were 20-49. Maxilla-mandible ratio was 1.37∶1. Conclusions: There was no gender preference for odontogenic tumors in Jilin Province area in the 57 years. The majority tumors occurred in the radicular. The most common pathological type was ameloblastoma. As for odontogenic cysts, males showed a higher incidence and the majority cysts occurred in the maxilla. The most common pathological type was radicular cysts.

[A case report of multiple dentigerous cyst of mandible and review of literature].

Dentigerous cyst belongs to one kind of odontogenic cysts, and is also known as follicular cyst. After the formation of the crown or root of the tooth, liquid exudates between the residual enamel epithelium and the crown surface to form odontogenic cysts. Multiple odontogenic cysts are rare in the oral and maxillofacial regions, especially in different areas of the jaw. In this paper, we reported case with multiple odontogenic cysts and discussed its etiology,pathological classification,differential diagnosis and treatment.

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.