Considering that dentigerous cysts are the second most common developmental odontogenic cyst that is likely to affect you, it is important to be well-versed with the symptoms and treatment options for this oral condition.
There exist several different types of cysts that can be seen in the oral cavity. The presence of these cysts can be attributed to the teeth that have erupted or teeth that are impacted in the oral cavity. Of these different types, one of the most common types of cyst is the dentigerous cyst. To be precise, it is the second most common developmental odontogenic cyst, and is said to account for one-fifth of all jaw cysts cases.
Dentigerous cyst is a cyst that usually surrounds the crown of an impacted tooth, and is seen due to fluid accumulation that takes place between the enamel surface of the tooth and the layer known as reduced enamel epithelium. Thus, this leads to the appearance of a cyst – wherein the crown is located within the lumen of the cyst. This kind of cyst is almost always seen in relation with a permanent tooth, and it is extremely rare for it to occur in relation with a deciduous tooth. It is not exactly known as to what instigates or leads to this kind of fluid accumulation which eventually results in formation of a cyst. While the causes are unclear, the signs and symptoms of a this condition exist in plenty and they play a crucial role in the diagnosis of this problem.
Signs and Symptoms
As we mentioned earlier, this cyst is always associated with the crown of an impacted or unerupted tooth in the oral cavity, and thus, it is usually seen in the region of the maxillary and mandibular third molars. At times though, it may also be seen in relation with the upper canine, especially if the same is impacted. It can also be seen in association with supernumerary teeth. This lesion is normally seen in people in their 20s and 30s, and males have a slight predilection for this condition. These cysts are normally solitary in nature, while bilateral or multiple cysts are normally seen in conjunction with other syndromes.
Dentigerous cyst do have a potential to become aggressive though. If these cysts increase in size, it can lead to expansion of bone, leading to a visible extra-oral swelling and subsequent facial asymmetry. More importantly, it can increase in size to such an extent that it can eventually displace adjacent teeth, thus causing a lot of pain and discomfort. In some cases – especially when the cyst is very severe, it can even take up the entire angle of the mandible, and cause it to become hollowed out, thus making it very weak and compromised. If the cyst increases in size to an extent where it does not lead to any extra-oral symptoms, then it is usually asymptomatic and painless, unless it becomes infected.
A radiograph of the affected region can show a radiolucency associated with the unerupted crown. The space between the cyst lining and the tooth will usually be more than five millimeters. There exist different types of dentigerous cyst; depending on how the cyst envelopes the crown (as seen on the radiograph), it is classified as a central dentigerous cyst or a lateral or a circumferential one. At times, a sclerotic lining – which indicates a bony reaction, may also be seen surrounding the cyst.
Surgical intervention is the only way to deal with a dentigerous cyst – as no medicine can help you abate it. If the lesion is small, then a simple surgical removal of the impacted tooth along with the entire cyst and cystic lining is the best way to deal with the cyst. However, if the lesion is very large with a lot of bone loss, then surgical drainage or marsupialization may be required. Simple surgical removal of a large cyst is not feasible due to the risk of fracture of the jaw involved. If the entire cyst and most importantly, the cystic lining is removed then the chances of recurrence are minimal.
The dentigerous cyst is a relatively common dental health condition that is asymptomatic in nature. However, even if the slightest symptoms do crop up, it is best to take immediate action and get the cyst and the impacted tooth in question removed immediately. There are chances that a few possible complications may stem from this cyst type, including the development of an ameloblastoma or an epidermoid carcinoma, if it is not subjected to proper treatment at the earliest. At the end of the day, any cyst that may be seen in relation with an impacted tooth must be investigated and treated at the earliest so as to minimize the risks of any future complications.