Dentigerous Cyst
Dentigerous cysts arise from the dental follicle.
Two prominent theories explain their formation
Fluid Accumulation Theory:
- Fluid accumulates between the Reduced Enamel Epithelium (REE) and the crown of the tooth.
- This causes pressure, leading to the proliferation of the REE into a cyst.
Breakdown of Stellate Reticulum:
- Fluid forms between the Inner Enamel Epithelium (IEE) and Outer Enamel Epithelium (OEE).
- This incites the proliferation of the outer enamel epithelium, resulting in cyst formation.
Notable Features
Clinical Features
- Associated with the 3rd molar in the mandible.
- 2nd most frequent location: maxillary canine region, followed by the posterior maxilla.
- Peak incidence in teens (20s).
- Male: female = 1.6:1.
- Can attain 10-15 cm.
- Not painful unless secondarily infected or the size creates a pathologic fracture.
- Bony expansion and facial fullness.
Radiological Features
- Three Variants:
- Central
- Lateral
- Circumferential
- Smooth, unilocular lesion, but multilocular may occur.
- Radiolucent area surrounded by a thin sclerotic line representing bony reaction.
Histological Features
Inflamed Cyst:
- Rete ridges.
- Rushton bodies.
- Cholesterol clefts.
Uninflamed Cyst:
- Lining resembles REE.
- Constitutes 2-3 rows of cuboidal or flattened epithelium.
- Mucous cells present.
- Wall is composed of mucopolysaccharides.
- Dystrophic calcifications present.
Treatment Options
- Enucleation
Preferred treatment and widely performed at Richardson’s Face Hospitals, known for the Best Cysts and tumor removal in India. - Marsupialisation
Less ideal, as it runs the risk of allowing an ameloblastoma in situ or a microinvasive ameloblastoma or other neoplastic transformations of the cyst lining to develop into a more invasive disease. - Caldwell-Luc
Used for large dentigerous cysts in the maxilla.
Consultation
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