Description of Dentigerous cyst in detail

1. PRESENTED BY :-
HIMANI THAWALE
(INTERN)
DENTIGEROUS
CYST

2. DEFINATION:-
 Dentigerous cyst can be defined as an odantogenic
cyst that surrounds the crown of an impacted
tooth; caused by fluid accumulation between the
reduced enamel epithelium and the enamel surface
resulting in the cyst in which the crown is located
within the lumen.

3. PREVALANCE:-
 This is one of the most common type of
developmental odontogenic cyst - 20% of all jaw cyst.
 10% of impacted teeth have formed a dentigerous
cyst.
 Frequency in the general population has been
estimated at 1.44 cyst for every 100 unerupted teeth.

4. CLINICAL FEATURES:
 Age:- second and third decade of life.
 Sex:- male prediliction
 Most common site:- 1) mandibular third molar
2) maxillary third molar
3) maxillary cuspid areas
(since these are most commonly impacted teeth)
 Most dentigerous cyst are solitary.

5.  Bilateral and multiple cyst are usually found in
association with number of syndromes including:-
- Cleidocranial dysplasia
- Maroteaux- lamy syndrome.
 Dentigerous cyst is capable of becoming an aggressive
lesion.
 Cystic involvement of an unerupted mandibular third
molar may result in “hollowing out” of entire ramus
 In case cyst is associated with a maxillary cuspid ,
expansion of anterior maxilla often occurs & may
superficially resemble an acute sinusitis or cellulitis.
 No pain or discomfort is associated with the cyst unless
it become secondarily infected.

6. RADIOGRAPHIC FEATURES:-
 Three radiological variations of dentigerous cyst are seen
radiographically:-
 Central type:-
In this type the crown is enveloped symmetrically.
 Lateral type:-
This type of radiographic appearance results from
dilation of follicles on one aspect of crown.
 Circumferential type:-
This type results when the follicle expands in a manner in
which the entire tooth appears to be involved by the cyst

8. HISTOLOGIC FEATURES:-
 It is usually composed of thin connective tissue wall with a
thin layer of stratified squamous epithelium lining the lumen.
 Rete peg formation generally absent unless it is secondarily
infected.
 Inflammatory cells and infiltration of connective tissue is
common.
 Presence of rushton bodies within the lining epitehlium is
usually seen with the cyst exhibiting inflammation.
 The content of cystic lumen is thin, watery yellow fluid
,ocasionaaly blood tinged

9. TREATMENT:-
Treatment usually is dictated by size of lesion:-
 Enucleation:- Smaller lesions are surgically removed
entierly
 Marsupilization :- The large cyst which involves severe
bone loss are treated by marsupilization.

10. COMPLICATIONS:-
 Ameloblastoma
 Squamous cell carcinoma
 Mucoepidermoid carcinoma