What is Odontogenic Cyst?
The process of development of the tooth is called odontogenesis. The cyst that is formed in the jaw during this process of odontogenesis is known as an odontogenic cyst. They are also related to the formation of odontogenic tumors. Any type of cysts or tumors that are harmful to the jaws are known to develop from any other type of tissue that are not involved in the process of tooth development. Therefore, dental cysts can be either odontogenic or non-odontogenic.
What is a Dentigerous Cyst?
Dentigerous cyst is a type of odontogenic cyst. These cysts are filled with fluids, and they are known to develop in the soft tissues and bones of the jaws. It is the second most common type of cysts that are known to develop from an odontogenic origin. The teeth which are not erupted properly into the oral cavity can serve as a contributing factor for the dentigerous cyst. A dentigerous cyst is also known as follicular cysts. Some cysts do not have an epithelial lining. But, the dentigerous cyst has a properly lined epithelium.
What Are the Causes of Dentigerous Cyst?
The cysts are always associated with the crown that is failed to erupt into the oral cavity. Even in crowns that are partially erupted, there are chances for the occurrence of the dentigerous cyst. For clinical purposes, the crown is categorized as impacted, partially erupted, and unerupted teeth. The genetic reasons can also contribute to the occurrence of a dentigerous cyst.
What Are the Features of Dentigerous Cyst?
The dentigerous cyst does not cause any pain in the majority of the patient. Most of the cases of the dentigerous cyst are known to occur in the lower jaw. These cysts can affect both genders. Most of the time, it is not possible to detect cysts in a clinical setup because it is usually identified as an incidental finding during a radiographic examination that is done for other purposes. People who are of the age group 20 to 30 years are affected by the dentigerous cyst. The occurrence of this type of cysts in the primary teeth (milk teeth) is very rare. Males are more commonly affected than females. There are no possible causes for the occurrence of dentigerous cyst in males.
Medical reports suggest that the common site of occurrence of the dentigerous cyst was noted in the back teeth that are present in the upper jaw. The canines and molars that are present in the lower jaw were also affected. The other possibility where dentigerous cyst can occur is on the lowermost portion of the supernumerary tooth.
What Are the Types of Dentigerous Cyst?
There are three types of a dentigerous cyst.
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Central variant. The cyst completely surrounds the crown, and the crown of the tooth is located in the center.
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Lateral variant. This type of cyst is located on the tooth that has mesioangular impaction. The cyst surrounds the side portion of the root surface.
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Circumferential variant. This type is similar to the central variant, but it is known to extend along the root surface. A portion of the root lies embedded in the cyst.
What Are the Conditions Associated With Dentigerous Cyst?
The following conditions are associated with the dentigerous cyst.
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Basal cell nevus syndrome.
In Maroteaux-Lamy syndrome and cleidocranial dysplasia, this condition usually occurs as multiple cysts. In other cases, it is usually seen only as a single cyst.
What Are the Symptoms of Dentigerous Cyst?
The cysts that are larger than two centimeters are known to show the following symptoms.
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Swelling. It can occur on one or both sides, depending on the involvement of the cyst.
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Tooth displacement. The normal position of the tooth is changed due to the occurrence of the cyst.
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Tooth sensitivity. The teeth will experience sensitivity to hot and cold objects.
What Are the Complications of Dentigerous Cyst?
The most common complication of dentigerous cyst is the occurrence of ameloblastoma. In untreated cases of the dentigerous cyst, the development of various types of ameloblastoma is noted. The other complications of the dentigerous cyst are:
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Fracture of the jaw. This might occur only in severe cases where the bone has been destroyed.
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Infection.
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Mucoepidermoid carcinoma.
How Is Dentigerous Cyst Diagnosed?
The diagnosis for dentigerous cyst requires both confirmatory tests for the dentigerous cyst and additional tests to rule out the other conditions like a periapical cyst and aneurysmal bone cyst. Eliminating these two conditions is necessary because they might resemble dentigerous cysts.
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The histological finding is an important part of the diagnosis.
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IOPA (Intra-oral periapical radiograph): Initially, a dental IOPA is taken to visualize the presence of a cyst. The cyst appears as a radiolucent area in the X-ray. The size of the cyst can also be predicted to a certain extent.
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OPG (orthopantomography): If multiple cysts are suspected, then an OPG is required.
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CT (Computed Tomography): It is a very helpful tool that will help in identifying the involvement of cyst in other structures like paranasal sinuses.
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MRI: Magnetic Resonance Imaging is a technique that is helpful for distinguishing cystic lesions from others. They are graded as follows:
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T1: It indicates a low signal and is similar to water or CSF.
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T2: It indicates a high signal and is similar to water or CSF.
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T1 C+ (Gd): It indicated that there is no solid component.
What Are the Treatment Options for Dentigerous Cyst?
The treatment of dentigerous cyst is aimed at the removal of the cyst along with its entire contents. Any possibilities for making the unerupted tooth to erupt is also considered. The orthodontic procedures to align the teeth are required. The two important surgical procedures that are involved in the removal of the dentigerous cyst are enucleation and marsupialization.
Enucleation: If there is no involvement of the important structures associated with the cyst, then enucleation surgery is planned. The tooth that is associated is also removed in this procedure.
Marsupialization: Marsupialization is a surgical procedure in which the cyst is removed with an incision. All the fluids can be easily drained. After the fluid is drained, suturing of the edges are done to form a pouch or a pocket.
What Is the Differential Diagnosis for Dentigerous Cyst?
The differential diagnosis for dentigerous cyst are:
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Stafne cyst.
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Keratocystic tumor (odontogenic keratocyst).
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Cherubism (fibrous dysplasia).
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