Jacobs Journal of Dentistry and Research

Bilateral Dentigerous Cyst Regression: A Comprehensive Review of the Literature and Report of an Unusual Case

*Mohit Chand
Department Of Orthodontics, United Kingdom

*Corresponding Author:
Mohit Chand
Department Of Orthodontics, United Kingdom
Email:Mohit.chand@nhs.net

Published on: 2019-03-11

Abstract

The dentigerous cyst is the most common cause of a pericoronal radiolucency involving an impacted mandibular third molar. Bilateral or multiple dentigerous cysts have been reported in patients with syndromes such as cleidocranial dysplasia however non-syndromic cases are much rarer. This report reveals a 54-year-old Caucasian lady who presented with asymptomatic bilateral radiolucencies associated with impacted lower third molars, which were incidentally noted upon taking a panoramic radiograph for an unrelated pathology. A decision was made alongside the patient, to not surgically intervene, accepting the risks involved. Upon 12-month review, bilateral regression was noted on a follow up panoramic radiograph. Without histopathological analysis a definitive diagnosis is impossible however the lesions radiologically strongly support the diagnosis of dentigerous cysts. With no history of pericoronitis or dental treatment in the interim period it is difficult to explain the regression. The most likely explanation would be a rupture of the cystic lining, leading to a communication with the oral cavity via the periodontal ligament of the lower second molar’s distal root, creating a marsupialisation effect. Extensive search identified bilateral cyst regression without treatment as an extremely rare occurrence, with this case being the only ever report of its kind.

Keywords

Bilateral or multiple dentigerous cysts; Cleidocranial Dysplasia; Maroteaux – Lamy syndrome; Malignant, Transformation Ratio

Introduction

The dentigerous cyst is the most common cause of a pericoronal radiolucency involving an impacted mandibular third molar [1]. It is the second most common odontogenic cyst with a prevalence of approximately 25%. It is defined as having a lining that attaches at the cementoenamel junction (CEJ) of an unerupted tooth, encapsulating the crown [2]. The cyst is thought to develop by accumulation of fluid between reduced enamel epithelium and enamel or within the enamel organ [3]. Its lining consists of two to four cell layers of flat or cuboidal epithelium [4]. Though variable in size, radiographically, the cyst usually presents as a unilocular radiolucency with a well-defined sclerotic border [5].