Cisto dentígero: diagnóstico e tratamento

O cisto dentígero é um cisto odontogênico que é classificado como de desenvolvimento. Normalmente, está relacionado à coroa de um dente incluso, sendo um dos cistos odontogênicos mais frequentes nos ossos gnáticos. Na maioria das vezes é diagnosticado em pacientes entre a segunda e a terceira década de vida, com grande ocorrência em terceiros molares inferiores e caninos superiores. Clinicamente, apresenta evolução lenta, assintomática e pode causar discreta deformidade facial, deslocamento de dentes e alterações de estruturas na região. Radiograficamente, os cistos dentígeros são descritos como lesões radiolúcidas bem delimitadas e uniloculares. Na maioria dos casos, são observados em exames de rotina ou durante a pesquisa da causa da não erupção de um dente permanente. Apesar da singularidade clínica de cada caso, o prognóstico dessa lesão é favorável. O tratamento para o cisto dentígero pode ser a marsupialização em casos de lesões grandes, enucleação com exodontia do dente incluso ou preservação do elemento dental. Este trabalho visa apresentar um caso clínico de cisto dentígero em região posterior de mandíbula, abordando aspectos clínicos, imaginológicos, histopatológicos e terapêuticos, com a finalidade de familiarizar o cirurgião dentista com tal lesão.Descritores: Cisto; Cisto Dentígero; Diagnóstico Bucal.ReferênciasJones TA, Perry RJ, Wake MJ. Marsupialization of a large unilateral mandibular dentigerous cyst in a 6-year-old boy – a case report. Dent Update. 2003;30(10):557-61.Chapelle KOM, Stoelinga PJ, de Wilde PC, Brouns JJ, Voorsmit RA. Rational approach to diagnosis and treatment of ameloblastomas and odontogenic keratocists. Br J Oral Maxilofac Surg. 2004;42(5):381-90.Sampaio RK, Prado R. Cirurgia dos cistos odontogênicos. In: Prado R, Salim M. Cirurgia bucomaxilofacial: diagnóstico e tratamento. Belo Horizonte: Medsi; 2004. p. 365-407.Ustuner E, Fitoz S, Atasoy C, Erden I, Akyar S. Bilateral maxillary dentigerous cysts: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003; 95(5):632-35.Tsukamoto G, Sasaki A, Akyama T, Ishikawa T, Kishimoto K, Nishiyama A et al. A radiologic analysis of dentigerous cyst and odontogenic keratocysts associated with a mandibular third molar. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;91(6):743-47.Daley TD, Wysocki GP. The small dentigerous cyst. A diagnostic dilemma.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995;79(1):77-81.Regezi JA, Sciubba JJ. Patologia bucal: correlações clinicopatológicas. Rio de Janeiro: Guanabara Koogan; 2000.Shafer WG, Hine MK, Levy BM. Tratado de patologia bucal. 4. ed. Rio de Janeiro: Guanabara Koogan; 1987.Aziz SR, Pulse C, Dourmas MA, Roser SM. et al. Inferior alveolar nerve paresthesia associated with a mandibular dentigerous cyst. J Oral Maxillofac Surg. 2002;60(4):457-59.Hyomoto M, Kawakami M, Inoue M, Kirita T. Clinical conditions for eruption of maxillary canines and mandibular premolars associated with dentigerous cysts. Am J Orthod Dentofac Orthop. 2003;124(5):515-20.Thosaporn W, Iamaroon A, Pongsiriwet S, Ng KH. A comparative study of epithelial cell proliferation between the odontogênic keratocyst, orthokeratinized odontogenic cyst, dentigerous cyst, and ameloblastoma. Oral Dis. 2004;10(1):22-6.Neville BW, Damm DD, Allen CM, Bouquot JE. Patologia Oral & Maxilofacial. 4.ed. Rio de Janeiro: Guanabara Koogan; 2016.Bajaj MS, Mahindrakar A, Pushker N. Dentigerous cyst in the maxillary sinus: a rare cause of nasolacrimal obstruction. Orbit. 2003;22(4):289-92.Kawamura JY, de Magalhães RP, Sousa SC, Magalhães MH. Management of a large dentigerous cyst occurring in a six-year-old boy. J Clin Pediatr Dent. 2004;28(4):355-57.Motamedi MH, Talesh KT. Management of extensive dentigerous cysts. Br Dent J. 2005;198(4):203-6.Ertas U, Yavuz S. Interesting eruption of 4 teeth associated with a large dentigerous cyst in mandible by only marsupialization. J Oral Maxilofac Surg. 2003;61(6):728-32.Kim SG, Yang BE, OH SH, Min SK, Hong SP, Choi JY. The differential expression pattern of BMP-4 between the dentigerous cystand the odontogenic keratocyst. J Oral Pathol Med. 2005;34(3):178-83.Benn A, Altine M. Dentigerous cyst of infl amatory origin: a cliniopathologic study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;81(2):203-9.Dunsche A, Babendererde O, Luttges J, Springer IN. Dentigerous cyst versus unicystic ameloblastoma – differential diagnosis in routine histology. J Oral Pathol Med. 2003;32(8):486-91.Fortin T, Coudert JL, Francois B, Huet A, Niogret F,Jourlin M et al. Marsupialization of dentigerous cyst associated with foreign body using 3D CT images: a case report. J Clin Pediatr Dent. 1997;22(1):29-33.Martínez-Pérez D, Varela-Morales M. Conservative treatmentof dentigerous cysts in children: report of four cases. J Oral Maxillofac Surg. 2001;59(3):331-34.Vaz LGM, Rodrigues MTV, Ferreira Júnior O. Cisto dentígero: características clínicas, radiográficas e critérios para o plano de tratamento. RGO. 2010;58(1):127-30.

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Maxillary Dentigerous Cyst Associated With Supernumerary Tooth

Bengal Journal of Otolaryngology and Head Neck Surgery ◽

10.47210/bjohns.2019.v27i1.232 ◽

2019 ◽

Vol 27 (1) ◽

Author(s):

Prashant Nanwani

Keyword(s):

Case Report ◽

Dentigerous Cyst ◽

Third Molar ◽

Developmental Abnormality ◽

Supernumerary Tooth ◽

Anterior Maxilla ◽

Present Case Report ◽

Dentigerous Cysts ◽

Enamel Epithelium ◽

Reduced Enamel Epithelium

Introduction Dentigerous cysts are caused by a developmental abnormality derived from the reduced enamel epithelium of the tooth-forming organ. Dentigerous cyst rarely involve impacted supernumerary tooth in anterior maxilla while commonly involve third molar tooth. Case Report A case of dentigerous cyst in association with supernumerary tooth in a 15-year-old male patient is reported causing right nasal cavity obstruction. The present case report describes the management of a dentigerous cyst by surgical enucleation.

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Surgical Approach to Dentigerous Cyst with Protection of the Inferior Alveolar Nerve

Balkan Journal of Dental Medicine ◽

10.1515/bjdm-2016-0029 ◽

2016 ◽

Vol 20 (3) ◽

pp. 178-181

Author(s):

Stylianos Dalampiras ◽

Georgios-Alexandros Vakirtzian ◽

Foivos-Antonios Dalampiras ◽

Maria Dalampira

Keyword(s):

Case Report ◽

Surgical Approach ◽

Surgical Planning ◽

Dentigerous Cyst ◽

Inferior Alveolar Nerve ◽

Radiographic Examination ◽

Dentigerous Cysts ◽

Surgical Field

Summary Aim: To stress the importance of surgical planning when treating large dentigerous cysts. Case Report: In a routine radiographic examination, a dentigerous cyst was revealed in a 20 years old male. A surgical approach that ensured the integrity of the inferior alveolar nerve (IAN) was applied. The incision was exceeded to the mesial surface of the first molar in order to create adequate surgical field and visibility. The final result was that the exposed nerve was protected successfully. Conclusion: This case shows the necessity of a meticulous preparation, even in routine operations.

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Infected Dentigerous Cyst of Maxillary Sinus Arising from an Ectopic Third Molar

Journal of Clinical Imaging Science ◽

10.4103/2156-7514.117461 ◽

2013 ◽

Vol 3 ◽

pp. 7 ◽

Cited By ~ 4

Author(s):

Yadavalli Guruprasad ◽

Dinesh Singh Chauhan ◽

Umashankar Kura

Keyword(s):

Maxillary Sinus ◽

Rare Case ◽

Dentigerous Cyst ◽

Third Molar ◽

Radiographic Examination ◽

Palpable Mass ◽

Follicular Cyst ◽

Pathologic Features ◽

Dentigerous Cysts ◽

Ectopic Third Molar

A dentigerous cyst or follicular cyst is a form of odontogenic cyst. It is believed that it forms during the development of the tooth and is associated with pressure exerted by the crown of an unerupted (or partially erupted) tooth on the fluid within the follicular space. Typically, dentigerous cysts are painless and discovered during routine radiographic examination. However, they may be large and result in a palpable mass. Additionally, as they grow they displace adjacent teeth. They almost exclusively occur in permanent dentition. The cyst is lined by stratified squamous non-keratinizing epithelium. About 70% of dentigerous cysts occur in the mandible and 30% in the maxilla. Dentigerous cysts associated with ectopic teeth within the maxillary sinus are very rare. We report radiologic and pathologic features in a rare case of infected dentigerous cyst of maxillary sinus arising from an ectopic third molar in a 21-year-old female patient.

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Tratamento cirúrgico do ceratocisto odontogênico por meio de enucleação e osteotomia periférica: relato de caso

ARCHIVES OF HEALTH INVESTIGATION ◽

10.21270/archi.v9i6.4776 ◽

2020 ◽

Vol 9 (6) ◽

pp. 531-534

Author(s):

Diogo Henrique Marques ◽

Maylson Alves Nogueira Barros ◽

Vitor Bruno Teslenco ◽

Cláudio Marcio Santana Junior ◽

Lucas Marques Meurer ◽

...

Keyword(s):

Case Report ◽

Meta Analysis ◽

Benign Lesion ◽

Dentigerous Cyst ◽

Case Series ◽

Odontogenic Keratocyst ◽

Imaging Features ◽

Retrospective Case ◽

Odontogenic Keratocysts

Introdução: Os ceratocistos odontogênicos (CCA) são considerados raros cistos de desenvolvimento, derivados dos remanescentes da lâmina dentária, com atividade intraóssea benigna, porém localmente invasivo e agressivo. O tratamento para o ceratocisto odongênico é variado, podendo-se encontrar modalidades tais como:enucleação, isolada ou associada a curetagem, com osteotomia periférica, aplicação da solução de Carnoy ou crioterapia, descompressão, marsupialização e ressecções. Objetivo: O presente trabalho tem como objetivo relatar um caso de ceratocisto odontogênico, onde foi escolhida abordagem conservadora por curetagem e osteotomia periférica. Relato de caso: Paciente de 68 anos, leucoderma, referiu ao exame clínico dor espontânea em região retromolar esquerda e parestesia em lábio inferior. A paciente foi submetida a biopsia por aspiração e excisional, após confirmação histopatológica foi proposto uma enucleação associada a osteotomia periférica sob anestesia geral. A paciente permanece em acompanhamento clínico e radiográfico, sem sinais de recidiva da lesão. Conclusão: Embora apresentem um comportamento agressivo, os ceratocistos odontogêncios podem ser tratados com segurança, de forma conservadora, por meio de enucleação seguida de osteotomia periférica com mínimo de morbidade. Descritores: Osteotomia; Curetagem; Cistos Odontogênicos. Referências Borghesi A, Nardi C, Giannitto C, Tironi A, Maroldi R, Di Bartolomeo F, Preda L. Odontogenic keratocyst: imaging features of a benign lesion with an aggressive behaviour. Insights Imaging. 2018 Oct;9(5):883-897. Park JH, Kwak EJ, You KS, Jung YS, Jung HD. Volume change pattern of decompression of mandibular odontogenic keratocyst. Maxillofac Plast Reconstr Surg. 2019 Jan 7;41(1):2. Karaca C, Dere KA, Er N, Aktas A, Tosun E, Koseoglu OT, Usubutun A. Recurrence rate of odontogenic keratocyst treated by enucleation and peripheral ostectomy: Retrospective case series with up to 12 years of follow-up. Med Oral Patol Oral Cir Bucal. 2018 Jul 1;23(4):e443-e448. Guerra LAP, Silva PS, Dos Santos RLO, Silva AMF, Albuquerque DP. Tratamento conservador de múltiplos tumores odontogênicos ceratocístico em paciente não sindrômico. Rev cir traumatol. buco-maxilo-fac. 2013; 13(2):43-50. Sundaragiri KS, Saxena S, Sankhla B, Bhargava A. Non syndromic synchronous multiple odontogenic keratocysts in a western Indian population: A series of four cases. J Clin Exp Dent. 2018;10(8):e831-6. Freitas AD, Veloso DA, Santos ALF, Freitas VA. Maxillary odontogenic keratocyst: a clinical case report. RGO Rev Gaúch Odontol. 2015; 63(4):484-88. Madhireddy MR, Prakash AJ, Mahanthi V, Chalapathi KV. Large Follicular Odontogenic Keratocyst affecting Maxillary Sinus mimicking Dentigerous Cyst in an 8-year-old Boy: A Case Report and Review. Int J Clin Pediatr Dent. 2018 Jul-Aug;11(4):349-351. Moura BS, Cavalcante MA, Hespanhol W. Tumor odontogênico ceratocistico. Rev Col Bras Cir., 2016;43(6):466-71. Valori FP, Costa E, Buscatti MY, Oliveira JX, Costa C. Tumor odontogênico queratocístico: características intrínsecas e elucidação da nova nomenclatura do queratocisto odontogênico. J Health Sci Inst. 2010;28(1):80-3. Slusarenko da Silva Y, Stoelinga PJW, Naclério-Homem MDG. The presentation of odontogenic keratocysts in the jaws with an emphasis on the tooth-bearing area: a systematic review and meta-analysis. Oral Maxillofac Surg. 2019;23(2):133-47.

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Ectopic Third Molar Associated With Dentigerous Cyst in Maxillary Sinus: A Case Report

Indian Journal of Public Health Research & Development ◽

10.37506/ijphrd.v13i1.17343 ◽

2022 ◽

Vol 13 (1) ◽

Keyword(s):

Case Report ◽

Maxillary Sinus ◽

Dentigerous Cyst ◽

Third Molar ◽

Ectopic Third Molar

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Peripheral ostectomy with the use of Carnoy’s solution as a rational surgical approach to odontogenic keratocyst: A case report with a 5-year follow-up

Vojnosanitetski pregled ◽

10.2298/vsp1212101m ◽

2012 ◽

Vol 69 (12) ◽

pp. 1101-1105 ◽

Cited By ~ 4

Author(s):

Stevo Matijevic ◽

Zoran Damjanovic ◽

Zoran Lazic ◽

Milka Gardasevic ◽

Dobrila Radenovic-Djuric

Keyword(s):

Case Report ◽

Surgical Treatment ◽

Third Molar ◽

Treatment Protocol ◽

Odontogenic Keratocyst ◽

Radiographic Evidence ◽

The Third ◽

Cortical Perforation ◽

Molar Region

Introduction. Odontogenic keratocyst (OKC) is a rare developmental, epithelial and benign cyst of the jaws of odontogenic origin with high recurrence rates. The third molar region, especially the angle of the mandible and the ascending ramus are involved far more frequently than the maxilla. The choice of treatment approach was based on the size of the cyst, recurrence status, and radiographic evidence of cortical perforation. Different surgical treatment options like marsupialization, decompression, enucleation, enucleation with Carnoy?s solution, peripheral ostectomy with or without Carnoy?s solution, and jaw resection have been discussed in the literature with variable rates of recurrence. Case report. We presented a 52-yearold male with orthokeratinized odontogenic keratocyst. Elliptical unilocular radiolucency located in the third molar region and the ascending ramus of the mandible, 40 ? 25 mm in diameter with radiographic evidence of cortical perforation at the anterior ramus border of the mandible 20 mm in diameter, was registrated on orthopantomographic radiography. Surgical treatment included enucleation of the cyst and peripheral ostectomy with the use of Carnoy?s solution and excision of the overlying attached mucosa. Postoperatively, no paresthesia in the inervation area of the inferior alveolaris nerve was registrated. Recurrences were not registrated within 5 years post-intervention. Coclusion. Treatment of odontogenic keratocyst with enucleation and peripheral ostectomy with the use of Carnoy?s solution and excision of the overlying attached mucosa had a very low rate of recurrence. Radical and more aggressive surgical treatments as jaw resection should be reserved for multiple recurrent cysts and when OKC is associated with nevoid basal cell carcinoma syndrome (NBCCS). Following the treatment protocol in the management of OKC and systematic and long-term postsurgical follow-up are considered key elements for successful results.

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Bilateral ectopic third molar in the maxillary sinuses associated with dentigerous cyst: a case report

Medicine and Pharmacy Reports ◽

10.15386/mpr-2072 ◽

2021 ◽

Author(s):

Antoine Berberi ◽

Georges Aoun ◽

Bouchra Hjeij ◽

Maissa AboulHosn ◽

Hiba Alassaad ◽

...

Keyword(s):

Dentigerous Cyst ◽

Third Molar ◽

Third Molars ◽

Unerupted Tooth ◽

Sinus Cavity ◽

Dentigerous Cysts ◽

Enamel Epithelium ◽

Ectopic Third Molar ◽

Reduced Enamel Epithelium ◽

Maxillary Sinuses

A dentigerous cyst is an epithelial-lined odontogenic cyst formed by an accumulation of fluid between the reduced enamel epithelium and the crown of an unerupted tooth. About 70% of dentigerous cysts occur in the mandible and 30% in the maxilla and the most involved teeth are maxillary canines and maxillary third molar. Dentigerous cysts often displace the related tooth into an ectopic position. In the maxilla when the cyst expands into the sinus, usually causes total or partial occupation of the sinus cavity and can extend to the nose. We report a rare case of a 24-year-old female with bilateral maxillary third molars inside the maxillary sinuses attached to a dentigerous cyst and treated with a minimally invasive endoscopic surgery through the middle meatal meatotomy.

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Spontaneous remission of the mandibular nerve paresthesia: a case report

ARCHIVES OF HEALTH INVESTIGATION ◽

10.21270/archi.v7i1.2283 ◽

2018 ◽

Vol 7 (1) ◽

Author(s):

Ronald Jefferson Martins ◽

Naiana de Melo Belila ◽

Mayumi Domingues Kato ◽

Cléa Adas Saliba Garbin

Keyword(s):

Case Report ◽

Correct Diagnosis ◽

White Male ◽

Inferior Alveolar Nerve ◽

Third Molar ◽

Spontaneous Remission ◽

Complete Recovery ◽

Nerve Fibers ◽

Mandibular Nerve ◽

Transient Loss

Introduction: Paresthesia is usually characterized by a transient loss of sensitivity in the area covered by the affected nerve. Different causes may lead to this occurrence; among them, the injury of nerve structures during the extraction of third molars. The sensitivity recovery depends on the regeneration of the nerve fibers, and in most cases it occurs spontaneously. In some situations, there is a need for a more invasive and expensive treatments to the patient. Objective: The aim of this study was to evaluate the spontaneous remission of the inferior alveolar nerve paresthesia. Case report: We studied a 34 year-old patient, white, male, which presented paresthesia of the inferior alveolar nerve after extraction of the lower right third molar. We chose to wait for the spontaneous return of the sensitivity, which occurred between the first and second postoperative month. Conclusion: The complete recovery of the sensitivity does not occur in all cases, even with the recommended treatments. So the best way to deal with paresthesia is prevention, where the dentist must perform the correct diagnosis with the aid of the necessary additional tests; besides having skill and dexterity in handling the instruments, so that the surgery would be performed safely and without any complications for the patient.Descriptors: Paresthesia; Remission, Spontaneous; Mandibular Nerve.

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Multiple unilateral accessory mandibular foramina-a case report

National Journal of Clinical Anatomy ◽

10.1055/s-0039-3401687 ◽

2012 ◽

Vol 01 (04) ◽

pp. 190-192

Author(s):

Anupama Mahajan ◽

Keyword(s):

Case Report ◽

Surgical Procedures ◽

Inferior Alveolar Nerve ◽

Third Molar ◽

Mandibular Canal ◽

Molar Tooth ◽

Posterior Border ◽

Mandibular Foramen ◽

Inner Surface ◽

Accessory Foramina

AbstractAccessory foramina in the mandible are known to transmit branches of nerves supplying the roots of the teeth. The mandibular foramen is present on the inner surface of the ramus of the mandible which transmits the inferior alveolar nerve. An adult human mandible of unknown sex was found to have multiple mandibular foramina on the medial surface of right ramus. A large accessory mandibular foramen was present anterosuperior to the main mandibular foramen. The dimensions were 6 mm antero posteriorly and 11mm vertically. The dimensions of the mandibular foramen were 9 mm antero posteriorly and 12mm vertically. The distance between two foramina was 20 mm and between the accessory mandibular foramen and apex of lingula was 7 mm. The distance between the posterior border of the accessory mandibular foramen and posterior border of ramus were 15 mm. The accessory mandibular foramen led into a canal which was directed obliquely and joined the mandibular canal at the level of third molar tooth. Two more small mandibular foramina were present one just below the accessory mandibular foramen discussed above and second near the main mandibular foramen. Both of them were of too small size to measure. The accessory mandibular foramen is a rare variation and awareness of its incidence and its position is necessary. The structures passing through it can be compromised during surgical procedures of this area.

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Dentigerous Cyst Associated with a Misaligned Maxillary First Premolar: A Case Report

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2021/v33i2031119 ◽

2021 ◽

pp. 170-175

Author(s):

Hassan Dib ◽

Sarah Farhat ◽

Antoine Berberi

Keyword(s):

Case Report ◽

Histological Examination ◽

Dentigerous Cyst ◽

Final Diagnosis ◽

Tooth Eruption ◽

Deciduous Teeth ◽

Odontogenic Cysts ◽

Dentigerous Cysts ◽

Facial Swelling ◽

Tissue Specimens

Aims: The main goal of the following case report was to shed the light on the importance of thorough clinical, radiological and histological examinations in order to elaborate a final diagnosis of asymptomatic dentigerous cysts detected in unusual locations. Presentation of Case: A case of dentigerous cyst was identified accidentally in the maxillary left premolar region of an asymptomatic 14-year-old female post an orthodontic consultation. Histological examination of the tissue specimens following enucleation confirmed the diagnosis of a dentigerous cyst. Discussion: Dentigerous cysts are the second most common odontogenic cysts after radicular cysts. They involve impacted, un-erupted, permanent, supernumerary, odontomas and rarely deciduous teeth. Dentigerous cysts are usually painless but may cause facial swelling and delayed tooth eruption. Extensive maxillary involvement and childhood presentation are rare. Radio-graphic and histological examinations should be done to confirm the diagnosis of a dentigerous cyst. Conclusion: In our case, we showed the presence of a maxillary premolar dentigerous cyst that was removed by enucleation. The presence of dentigerous cyst is not always associated with a syndrome and its removal is very important to avoid future complications.

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