This document discusses dentigerous cysts, including their definition, pathogenesis, clinical features, radiological features, histological features, investigation, treatment, and potential complications. A dentigerous cyst is an odontogenic cyst that forms around the crown of an unerupted tooth due to fluid accumulation between the reduced enamel epithelium and enamel surface. Clinically, they usually appear as asymptomatic swellings but can cause expansion of the bone. Radiographically, they appear as well-defined radiolucencies that surround the crown of an unerupted tooth. Treatment involves surgical removal of the cyst lining either through enucleation or marsupialization along with removal of the associated tooth. Complications can include

1. DENTIGEROUS CYST WITH EMPHASIS ON ITS
COMPLICATIONS
DR.KRISHNA MOHAN
POST GRADUATE STUDENT
DEPT. OF ORAL PATHOLOGY
SRM DENTAL COLLEGE

2. SYNOPSIS
CYST - 1) DEFINITION
2) CLASSIFICATION
3) PATHOGENESIS
DENTIGEROUS CYST -
DEFINITION
TERMINOLOGY
EPIDEMIOLOGY
CLASSIFICATION
CLINICAL FEATURES
RADIOLOGICAL FEATURES
HISTOLOGICAL FEATURES
INVESTIGATION
TREATMENT
COMPLICATIONS

3. STAGES OF TOOTH DEVELOPMENT
• Bud stage
• Cap stage
• Bell stage –Early bell stage
-Late (or)advanced bell stage

8. CYST
A cyst is pathologic cavity
having fluid, semifluid, or
gaseous contents that are not
created by the accumulation of
pus; frequently, but not always,
is lined by epithelium .
KRAMER’S(1974)

9. TYPES OF CYST
TRUE CYSTS :
Cysts which are lined by
epithelium, E.g. Dentigerous
Cyst, Radicular Cyst, etc.
PSEUDO CYSTS :
Cysts which are not lined
by epithelium, E.g. Solitary
Bone Cyst, Aneurysmal Bone
Cyst,Traumatic bone cyst etc.

10. CLASSIFICATION (WHO 1992 )

11. WHO 2005

12. WHO 2017

13. SHEAR CLASSIFICATION
According to Shear cysts are classified under three main
headings:
I ) Cysts of the jaws
II) Cysts associated with the maxillary antrum
III Cysts of the soft tissues of the mouth, face, neck and salivary
glands.

14. CYSTS OF THE JAWS
EPITHELIAL-LINED CYST NON-EPITHELIAL-LINED CYSTS
ODONTOGENIC NON ODONTOGENIC
• Gingival cyst of infants
• Odontogenic keratocyst
• Dentigerous cyst
• Eruption cyst
• Gingival cyst of adults
• llateral
• periodontal cyst
• Botryoid odontogenic
cyst
• Glandular odontogenic
cyst
• Calcifying
odontogenic cyst
• Midpalatal raphe cyst of
infants
• Nasopalatine duct cyst
• Nasolabial cyst
• Inflammatory origin
• Radicular cyst, apical and
lateral
• Residual cyst
• Paradental cyst and
• juvenile paradental cyst
• Inflammatory collateral
cyst
• Solitary bone cyst
• Aneurysmal bone cyst

15. CYSTS ASSOCIATED WITH THE MAXILLARYANTRUM
• Mucocele
• Retention cyst
• Pseudocyst
• Postoperative maxillary cyst
CYSTS OF THE SOFT TISSUES OF THE MOUTH, FACE AND NECK
• Dermoid and epidermoid cysts
• Lymphoepithelial cyst
• Thyroglossal duct cyst
• Nasopharyngeal cyst
• Thymic cyst

16. SHAFERS CLASSIFICATION
DEVELOPMENTAL
CLASSIFICATION BASED
ON ETIOLOGY
CLASSIFICATION BY
TISSUE OF ORIGIN
Dentigerous cyst
Eruption cyst
Odontogenic keratocyst
Gingival (alveolar)
cyst of newborn
Gingival cyst of adult
Lateral Periodontal cyst
Calcifying odontogenic cyst
Glandular odontogenic cyst.
INFLAMMATORY
Periapical
Residual periapical
(radicular) cyst
Paradental cyst
DERIVED FROM
RESTS OF
MALASSE
DERIVED FROM
DENTAL LAMINA (
REST OF SERRES)
Periapical cyst
Residual cyst
Derived from
reduced enamel
epithelial
Dentigerous cyst
Eruption cyst
Odontogenic keratocyst
Gingival (alveolar) cyst of
newborn
Gingival cyst of adult
Lateral Periodontal cyst
Calcifying odontogenic
cyst
Glandular odontogenic
cyst.

17. PATHOGENESIS OF CYST
• INITIATION
• CYST FORMATION
• ENLARGEMENT

18. INITIATION
Initiation results in the proliferation of the developing
odontogenic epithelial cells and the formation of small
cavity
• Cell Rests of Malassez
• Reduced Enamel Epithelium
• Cell Rests of Serres (Dental Lamina)

19. CYST ENLARGEMENT
Harris (1974) Postulated the theories
1) Mural growth - Peripheral cell division
2) Hydrostatic –Accumulated contents
3) Bone resorbing factor

20. DENTIGEROUS CYST
• Latin word
• Denti -Tooth
• Gerous - Bearing or Producing
• Also called follicular cyst or
pericoronal cyst
• Developmental odontogenic cyst
of epithelial origin.
• Occurs in association with an
unerupted tooth

21. DEFINITION
• An odontogenic cyst
that surround the crown
of impacted
tooth,caused by fluid
accumulation between
the reduced enamel
epithelium and enamel
surface ,resulting in a
cyst in which the crown
is located within the
lumen.

23. PATHOGENESIS
THEORY :TOLLERS ET AL
• INTRAFOLLICULAR
• EXTRAFOLLICULAR
INTRAFOLLICULAR :
It may develop by the accumulation of
fluid either between the reduced enamel
epithelium and the enamel or within
enamel organ itself.

25. According to Atkinson(1976)

26. ACCORDING TO AL-TALABANI AND
SMITH(1980)

28. CLINICAL FEATURE
• AGE: first to third decades
• SEX: equal in both sex
• SITE: maxilla-33%, mandible-
67%
• most frequently located in angle
of mandible, canine region of
maxilla & mandible
• maxillary 3rd molar area , rarely
at anterior segment
• Usually painless , pain arise when
secondary infection occurs
• If untreated-swelling became
large

29. • Expansion of bone with
subsequent facial
asymmerty
• Pus may discharge in case
of secondary infection

30. RADIOLOGICAL FEATURE
• Well defined radiolucent area
• unilocular or multilocular
radiolucency encircle the crown
of unerupted tooth

31. • Central variety
• Lateral variety
• Circumferential variety
CENTRAL CIRCUMFERENTIAL
LATERAL

32. EXPANSION

33. ASSOCIATED DISEASE
Bilateral cysts are found in
association with Basal cell
nevus syndrome, Cleidocranial
dysplasia and a rare form of
amelogenesis imperfecta.

34. HISTOLOGICAL FEATURE

36. CYST LINED BY THIN KERATINISED EPITHELIUM

37. CYST LINED BY NON KERATINISED
EPITHELIUM

38. CYST LINED BY CILIATED COLUMNAR
EPITHELIUM

39. MUCOUS CELLS SEEN WIHIN THE
EPITHELIAL LINING

40. EPITHELIAL LINING CONTAINING
RUSHTON BODIES

41. INFLAMMED DENTIGEROUS CYST

42. DENTIGROUS CYST IN PRIMARY
DENTITION
• Frequently in children is low
• 10 years of age.
• Periapical inflammation from a
non-vital primary tooth
• The spread of periapical
inflammation may affect the germ
of permanent tooth and may
induce the formation of a cyst.

43. INVESTIGATION
FNAC BIOPSY
OPG CT BLOOD TEST

44. TREATMENT
• Enucleation
• Marsupialisation
• Removal of associated tooth

45. POTENTIAL COMPLICATION OF
DENTIGEROUS CYST
• Ameloblastoma
• Mucoepidermoid carcinoma
• Squamous cell carcinoma

46. THANK YOU