Pediatr Infect Vaccine.  2015 Dec;22(3):201-205. 10.14776/piv.2015.22.3.201.

An Unusual Cause of Acute Maxillary Sinusitis in a 9-year-old Child: Odontogenic Origin of Infected Dentigerous Cyst with Supernumerary Teeth

• Yun HW
• Kwon HJ
• Woo IH
• Yang BE
• Lee SY
• Lee HR
• Kim KN

• KMID: 2315686
• DOI: http://doi.org/10.14776/piv.2015.22.3.201

Abstract

Acute maxillary sinusitis is a common disorder affecting children. Untreated acute sinusitis can develop into chronic sinusitis, and complications, such as orbital cellulitis or abscess, can occur. Maxillary sinusitis of odontogenic origin is not a well-recognized condition and is frequently missed in children. As an odontogenic source of sinusitis, the dentigerous cyst is one of the most prevalent types of odontogenic cysts, and it is associated with the crown of an unerupted or developing tooth. This report concerns a nine-year-old boy who was diagnosed with maxillary sinusitis originating from a dentigerous cyst with supernumerary teeth. The boy visited our pediatric clinic presenting with rhinorrhea and nasal obstruction and was initially diagnosed with maxillary sinusitis only. With antibiotic treatment, his symptoms seemed to improve, but after 2 months, he came to our clinic with left facial swelling with persistent rhinorrhea and nasal obstruction. Radiographic examinations of the sinuses were performed, and he was diagnosed with maxillary sinusitis originating from a dentigerous cyst with supernumerary teeth. After a surgical procedure involving the removal of the dentigerous cyst with supernumerary teeth, the symptoms of sinusitis gradually diminished. There are only very few cases in the pediatric medical literature that remind us that odontogenic origin can cause maxillary sinusitis in children. Our patient can act as a reminder to general pediatricians to include dentigerous cysts in the differential diagnosis of maxillary sinusitis.

Keyword

Maxillary sinusitis; Dentigerous cyst; Supernumerary teeth; Children

MeSH Terms

Abscess
Child*
Crowns
Dentigerous Cyst*
Diagnosis, Differential
Humans
Male
Maxillary Sinus*
Maxillary Sinusitis*
Nasal Obstruction
Odontogenic Cysts
Orbital Cellulitis
Sinusitis
Tooth
Tooth, Supernumerary*

Figure

• 

  Fig. 1. Paranasal sinus view of dentigerous cyst (thick arrow) with supernumerary tooth (thin arrow) in left maxillary sinus.

• 

  Fig. 2. Pre-operative panoramic view showed supernumerary teeth (arrows).

• 

  Fig. 3. Total of three supernumerary teeth cyst (thick arrows) and dentigerous cyst (dotted arrow) in initial cone-beam computed tomography (A, B). Supernumerary teeth (thick arrows) and dentigerous cyst (dotted arrow) are completely disappeared in repeated cone beam CT after 3 months (C, D).

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