What is a dentigerous cyst? Do you know what dental cyst is?

A dentigerous cyst is a cystic lesion associated with an unerupted or impacted tooth. Cyst formation is caused by abnormal proliferation of enamel epithelial tissue. So what is a dental cyst?

What is a dentigerous cyst?

A dentigerous cyst, also known as a follicular cyst, occurs after the formation of the tooth crown or root. Fluid exudates between the residual enamel epithelium and the tooth crown to form a dentigerous cyst. It usually comes from a single tooth germ, and clinically the cyst contains one tooth; it can also come from multiple tooth germs, and clinically the cyst contains multiple teeth. During the period of tooth replacement, the tooth-containing cyst formed when the permanent teeth are basically erupted is also called an eruption cyst.

Clinical manifestations

The peak age of onset of dentigerous cyst is between 10 and 39 years old; in childhood, the incidence of dentigerous cyst is slightly higher than that of other jaw cysts. Male patients are more likely to occur than females. The site of onset is related to age: patients under 10 years old mostly have lesions in the mandibular premolars, patients aged 10 to 20 years old mostly have lesions in the maxillary permanent canines, mandibular third molars and mandibular second premolars, and patients over 20 years old mostly have lesions in the mandibular third molars. The affected tooth has not erupted in the cyst area. The cyst grows slowly and expansilely, and its appearance is similar to that of a primordial cyst.

examine

1. Straw-yellow cyst fluid can be seen during puncture, and cholesterol crystals can be seen under a microscope.

2. X-ray shows a circular or elliptical transmission area with clear and neat edges. The cyst contains the crown of the tooth, which is mostly unilocular and a few are multilocular.

treat

The principle of treatment is cyst curettage. Both upper and lower jaw cysts can be treated with intraoral surgery. In addition to surgical removal of the cyst wall, the affected teeth contained in the cyst also need to be extracted. However, for children with dentigerous cysts during the eruption period, when it is estimated that the affected tooth may erupt to the normal position, the cyst cavity can be opened, the upper cyst wall can be removed, and the affected tooth can be retained to allow it to erupt naturally. The space between the teeth above should be maintained with a space maintainer to facilitate normal eruption.

For large odontogenic jaw cysts, especially those that are likely to suffer jaw fractures after curettage, plastic cystotomy can be performed, which involves opening the cyst from the inside of the mouth, removing part of the cyst wall and mucosa, and suturing the mucosa and cyst membrane together to connect the cyst cavity with the oral cavity and allow free drainage. Since there is no cystic fluid accumulation, the pressure is eliminated and the cystic cavity can gradually shrink and become shallower on its own. The remaining capsule can be removed surgically later, and since the dead space is not large, it is easier to close. Another advantage of this method is that the surgery can be performed only inside the mouth, without having to make an incision outside the mouth. Its disadvantage is that the treatment course is long, and attention should be paid to maintaining oral hygiene and close follow-up during the entire treatment process.