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Dentigerous cysts or follicular cysts can be developmental or inflammatory. Treatment of inflammatory cysts should be carried out conservatively without causing excessive damage to the posterior teeth. 1
How To Dental Cyst
A 13-year-old boy had a painless swelling in the region of the left lower back tooth for 1 month. An extraoral examination revealed a mild cheek bulge that was difficult to palpate. Intraoral examination revealed a grossly decayed 75. An orthopantomogram radiograph was recommended, which revealed a well-defined monocular radiographic reading of 75 (Figure 1). The radiolucency was also associated with undissolved 35 (Figure 2). A provisional diagnosis of an inflammatory dental cyst was made. Marsupialization of the cyst was designed to prevent unnecessary damage to the molar. Routine blood tests were recommended, which showed normal values.
D Render Of Teeth In Gums With Cyst Over White Background. Dental Problem Concept. Stock Photo, Picture And Royalty Free Image. Image 135818029
75 were extracted under local anesthesia. A thick, straw-colored liquid was drained during the procedure. Tissue from the cavity was sent for histological examination, which confirmed an inflammatory dental cyst (Figure 3). The buccal and lingual cortical plates were compressed and left open for drainage. The patient was prescribed antibiotics and painkillers and was discharged after the instructions.
Follow-up was performed after 1 week, 1 month (Figure 4), 3 months (Figure 5), 6 months (Figure 6) and 9 months (Figure 7).
After 9 months, 35 erupted in the oral cavity and the bones healed completely (Figure 8). The patient was advised to consult an orthodontist because of malignant teeth. Intramaxillary bone is the most common benign finding in the mouth and jaw area. The best treatment option for intraosseous cystic lesions is surgical removal (enucleation).
Cysts that contain vital anatomical structures may require decompression using procedures such as marsupialization. However, surgery often leads to postoperative complications: infection, recurrence, paresthesia and pathological fractures.
Multiple Jaw Cysts And Ectopic Calcification
However, it remains challenging for surgeons to predict the various preoperative factors that may influence the rate of complications.
This study retrospectively reviewed 249 patients, of which 262 cases had been surgically removed. All cystic lesions were removed by enucleation by a single surgeon. After enucleation, bone grafting with xenogeneic bone material or autogenous iliac bone was considered based on the size and configuration of the defect area. If the resulting defects were small or the pre-operative infection continued during the operation, a bone graft was usually not performed. Outcome variables were postoperative pathological infection, fractures and recurrence. Predictive variables included demographics (age and sex), comorbidities (diabetes and osteoporosis), anatomic factors (cyst location and size), pathologic diagnoses, and perioperative conditions (preoperative infection history, previous marsupialization, and bone grafts).
Cystic lesions were most commonly observed in the posterior jaw (132 cases), followed by the anterior jaw (74 cases), posterior jaw (29 cases), and ramus (16 cases). The most common lesion was dental cyst (135 cases), followed by periapical cyst (57 cases), OKC (37 cases), and nasopalatine duct cyst (26 cases). Marsupialization was performed in 20 cases, autogenous bone grafting was performed in 11 cases (4.2%). Xenogeneic bone graft was performed in 41 cases (15.6%). Primary closure without filling material was performed in 210 cases (80.2%).
IDENTIFICATION: Postoperative infection occurred in 59 cases (22.5%). Autogenous bone graft was a meaningful predictor of postoperative infection. (odds ratio [OR] = 7.56; P = 0.008). Xenogeneic bone graft was also associated with a higher infection rate compared with no bone graft, although this result was not statistically significant (OR = 2.13; P = 0.094). The incidence of postoperative infections was 63.6% (n = 7/11) when autogenous bone was transplanted, 26.8% (n = 11/41) in xenogeneic bone graft cases, and 19.5% (n = 41/210) without bone graft. . The maxillary and mandibular locations of cystic lesions were significant predictors of infection rate. The infection rate was highest in lesions located in the mandibular ramus, followed by posterior maxillary lesions. The presence of preoperative infection was not statistically associated with the incidence of postoperative infection
D Render Of Teeth With Wisdom Cyst Stock Illustration
RECURRENCES: Recurrences were observed in 7 cases (2.6%). 5 of these cases were diagnosed as OKC, 1 periapical cyst and 1 dentigerous cyst. Cyst size is significantly correlated with recurrence rate.
PARESTHESIA AND PATHOLOGICAL FRACTURES: Paresthesia after enucleation occurred in 38 cases (14.5%). Of these, 11 cases were associated with sacrifice or damage to the nasopalatine nerve. The other 27 cases occurred after enucleation of lesions invading the mandibular canal. Pathological fractures occurred in 4 (1.5%) mandibular angles. In these patients, the mean thickness of the remaining bone on panoramic radiographs was 7.3 mm.
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Dentigerous Cyst Of The Mandible In A Child
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A Dental Student’s Guide To…odontogenic Cysts
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By Roxana M. Talpos-Niculescu 1, *, † , Malina Popa 2, † , Laura C. Rusu 3 , Marius O. Pricop 4 , Luminita M. Nica 1, * and Serban Talpos-Niculescu 4
Dentigerous Cyst Formation Following Trauma To The Primary Incisors: A Case Report
Discipline of Restorative Dentistry and Endodontics, Research Center TADERP, Faculty of Dentistry, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
Discipline of Pedodontics, Pediatric Dentistry Research Center, Faculty of Dentistry, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
Discipline of Oral Pathology, Multidisciplinary Center for Oral Medicine Research, Evaluation, Diagnosis and Therapies, Faculty of Dentistry, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
Oral and Maxillofacial Surgery, Faculty of Dentistry, “Victor Babes” University of Medicine and Pharmacy, 300062 Timisoara, Romania
Cysts Of The Jaw
Received: 12/04/2021 / Revised: 28/04/2021 / Approved: 13/05/2021 / Published: 14/05/2021
Background and aims: Periapical cystic lesions are a pathology often presented to endodontic specialists. Although their treatment has not yet been standardized, the treatment should be as conservative as possible and with endodontic means, since they are lesions of endodontic origin. This case report describes two cases of upper central incisors with large cystic periapical lesions and their one-year follow-up. Materials and methods: Endodontic orthograde treatment was performed with abundant irrigation with sodium hypochlorite together with calcium hydroxide as an intracanal drug.
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