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Options to preserve teeth displaced by dental cysts

From Volume 7, Issue 3, July 2014 | Pages 99-102

Authors

Nigel Taylor

MDSc, BDS, FDS RCS(Ed), MOrth RCs(Ed), MDSc, BDS, FDS RCS(Ed), FDS RCS(Eng), FDTFed RCS(Ed), M'Orth RCS(Ed), D'Orth RCS(Eng), Consultant Orthodontist

Consultant Orthodontist, Royal Surrey County Hospital, Guildford, UK

Articles by Nigel Taylor

Abstract

These case reports illustrate the management of two patients presenting with a dentigerous cyst and nasopalatine cyst, respectively. Both patients were treated with different surgical approaches and the associated teeth were successfully aligned with orthodontic appliances.

Clinical Relevance: Dental practitioners should be suspicious if teeth are missing past the ideal age of eruption, especially if the contralateral tooth has been erupted for at least 6 months. Initial investigations should involve radiographs to identify presence, or otherwise, of the tooth and prompt referral when appropriate.

Article

Dentigerous cysts are epithelial-lined cavities, typically enclosing the crown of an unerupted tooth at the cemento-enamel junction. As the follicle expands, fluid collects between the reduced enamel epithelium and the enamel of the unerupted tooth, possibly through the production of cell breakdown products. Following impeded eruption of a tooth, an increase in osmotic pressure is said to occur which can result in cyst formation.1 A dentigerous cyst may be suspected if the follicular space around an unerupted tooth is greater than 5 mm, as a normal follicular space is considered to be in the region of 3 mm.1

Dentigerous cysts are the most prevalent odontogenic cysts, making up 24% of all these cysts2 and reach a peak incidence between the ages of 20 and 40. Any tooth may be involved but the mandibular third molars are the most commonly affected.

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