Imaging Sci Dent.  2012 Dec;42(4):255-260. 10.5624/isd.2012.42.4.255.

Dentigerous cyst associated with an impacted mesiodens: report of 2 cases

• Khambete N
• Kumar R
• Risbud M
• Kale L
• Sodhi S

• KMID: 1806793
• DOI: http://doi.org/10.5624/isd.2012.42.4.255

Abstract

Dentigerous cysts are the most common developmental cysts of the jaws, most frequently associated with impacted mandibular third molar teeth. Dentigerous cysts around supernumerary teeth, however, account for 5% of all dentigerous cysts, with most developing around a mesiodens in the anterior maxilla. This report describes two cases of a dentigerous cyst associated with an impacted mesiodens. Both of the patients complained of swelling in the maxillary anterior region. Radiographic examination revealed an impacted mesiodens surrounded by a large corticated radiolucency in both cases. A provisional diagnosis of infected odontogenic cyst was made. The cysts were enucleated with the removal of the mesiodens in the two cases. Histopathological examination confirmed the diagnosis of infected dentigerous cyst associated with an impacted mesiodens in both cases. The patients remained asymptomatic, and no complications were noted.

Keyword

Dentigerous Cyst; Tooth, Impacted; Tooth, Supernumerary

MeSH Terms

Dentigerous Cyst
Humans
Jaw
Maxilla
Molar, Third
Odontogenic Cysts
Tooth
Tooth, Impacted
Tooth, Supernumerary

Figure

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  Fig. 1 A. Clinical photograph shows a solitary diffuse extraoral swelling in the upper anterior region of the face. The tip of the nose is slightly deviated towards the right, and the left nasolabial fold is elevated. B. The intraoral photograph shows a solitary well-defined swelling in the maxillary anterior labial vestibule extending from the left central incisor up to the left first premolar in Case 1. The overlying mucosa is bluish in color, and the superficial blood vessels are prominent.

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  Fig. 2 A. Maxillary occlusal radiograph shows an impacted mesiodens surrounded by well-corticated radiolucency. B. Panoramic radiograph shows a well-corticated radiolucency in the anterior maxilla crossing the midline. C. Coronal and axial CT section show a large, radiolucent, well-defined lesion in the anterior maxilla with a supernumerary tooth.

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  Fig. 3 Postoperative photograph shows a large bone defect.

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  Fig. 4 Histopathological section of the lesion (H&E, ×10)

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  Fig. 5 A. Clinical photograph shows solitary diffused extraoral swelling in the upper anterior region of the face. It is anteroposteriorly extending from the tip of the nose to 1 cm lateral to the left ala of the nose and superoinferiorly extending from the ala-tragus line to the inferior border of the upper lip. The tip of the nose is slightly deviated towards the right along with elevation of the left nasolabial fold. B. Intraoral photograph shows a well-defined swelling in Case 2. A solitary well-defined intraoral swelling measuring about 3.5 cm×3 cm is seen in the maxillary anterior labial vestibule extending from the maxillary right lateral incisor to the maxillary left canine.

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  Fig. 6 A. Intraoral periapical radiograph shows well-corticated periapical radiolucency with an impacted mesiodens. B. Maxillary occlusal projection shows well-corticated radiolucency surrounding an impacted mesiodens. C. Panoramic radiograph shows well-corticated radiolucency in the anterior maxilla.

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  Fig. 7 Histopathological section of the lesion (H&E, ×10)

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