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Differential diagnosis between cyst and tumor. Dentigerous cyst and ameloblastoma containing teeth.

A study was conducted on 21 cases of ameloblastoma (a type of tumor containing an embedded tooth) and 87 cases of dentigerous cyst. The former cases were selected from among those which had been diagnosed histopathologically. Using radiographs of these lesions, the following parameters were measured: 1) the distance between the cement-enamel junction of the embedded tooth and its attachment to the cystic wall; 2) the area of the radiolucent image (similar to the area with a cystic appearance). From measurements of the former parameter, it appeared that the embedded tooth extends more toward the root apex in ameloblastoma than in dentigerous cyst, whereas the latter parameter indicated that the radiolucent area varies in size slightly in ameloblastoma, but tends to be smaller in dentigerous cyst. Moreover, with regard to clustering between ameloblastoma and dentigerous cyst, no definite tendency was detected on distance, whereas only ameloblastoma without dentigerous cyst was seen above 20 cm2 of area.

Adolescent

Dentigerous cysts associated with supernumerary teeth.

Dentigerous cysts associated with supernumerary teeth are rare and estimated to constitute 5-6% of all dentigerous cysts. They resemble the usual dentigerous cysts in terms of sex predilection and age distribution. The vast majority, about 90%, are associated with a maxillary mesiodens. The literature is reviewed and 6 additional cases reported.

Adult

A palatal dentigerous cyst arising from a mesiodente.

Dentigerous cysts can develop from unerupted primary, permanent, or rarely supernumerary teeth. When a supernumerary tooth is in the maxilla, near the midline, it is called a mesiodente. Such a mesiodente lies in the palate and a cyst developing about this tooth can extend directly up into the nasal fossae. More commonly a dentigerous cyst arising from unerupted maxillary teeth occurs about the molar, premolar, or canine teeth and the cyst extends up into the maxillary sinus. The CT and MR findings in a rare case of a dentigerous cyst of a mesiodente are presented.

Adult

A comparative stereologic and ultrastructural study of blood vessels in odontogenic keratocysts and dentigerous cysts.

Blood vessels were investigated both stereologically and ultrastructurally in keratocyst and dentigerous cyst. The volume and surface densities of blood vessels in 15 keratocysts and dentigerous cysts were analyzed stereologically. No significant differences were found between them using these parameters, suggesting that their overall vascularity may be similar. However, the ultrastructural study showed marked differences between blood vessels in these two types of cysts. It was observed that fenestrated capillaries were found only in keratocysts. In addition, degeneration of endothelial lining associated with thrombosis was also a prominent feature of this cyst. While ruptured endothelium, narrow lumen and Weibel-Palade bodies were characteristic of vessels in dentigerous cyst. The presence of fenestrated capillaries in keratocyst and not in dentigerous cyst might indicate a rapid transfer of fluid to meet the demand of the relatively active proliferating epithelium, which may be promoted by growth factors released from platelets in those thrombosed vessels.

Arterioles

Clinico-radiological aspects of dentigerous cysts.

The clinico-radiological features of 10 dentigerous cysts occurring in 6 patients are described. Dentigerous cysts are odontogenic cysts and may present directly as a painless jaw swelling or indirectly as an unerupted tooth. Radiologically, these cysts present as a pericoronal unilocular expansile translucencies the width of which exceeds 2.5 mm, with mandibular involvement predominating. Radiology plays an important role in detecting multiple cysts in a case presenting with a single cyst and also in detecting clinically asymptomic cysts in cases with delayed or non eruption of the teeth.

Adolescent

Case report of dentigerous cyst of lower incisor.

This paper reviews the pathogenesis, clinical features and the behaviour of dentigerous cyst. A case of mandibular dentigerous cyst involving the incisor tooth (an unusual site) is presented to illustrate this pattern of behaviour. A recurrent pyogenic granuloma in the region of the lower incisors prevented the eruption of the lower left incisor with subsequent cystic formation around the tooth. The histological and radiological presentation is consistent with that of a dentigerous cyst. The significance of the potential of the cyst lining is stressed. The cyst was enucleated with the associated tooth as the latter was not in a favourable position to erupt. There was no recurrence after one year of treatment.

Adolescent

Dentigerous cyst of the maxilla and its image diagnosis.

Dentigerous cysts may grow unnoticed to such extensive sizes as to occupy a considerable portion of the maxillary sinus. As they enlarge, the bony walls overlying the cysts thin out giving rise to an egg shell sensation upon palpation. Three cases of such extensive dentigerous cysts were experienced since 1987. These three cases were used to illustrate the advantages and disadvantages of the following imaging techniques in the preoperative evaluation of these cysts, conventional radiographs, sonography, CT, and MRI.

Adult

Respiratory epithelium within a mandibular dentigerous cyst.

A case report of a dentigerous cyst of the mandible with respiratory epithelium has been described. A review of the literature shows this to be only the fourth case reported. The three most current theories to explain this phenomenon have been presented.

Choristoma

[Dentigerous cyst. Review of the literature and report of a case].

A case of circumferential dentigerous cyst is presented, with a review of the literature. This lesion occurs when the tooth is exfoliated through the cystic epithelium surrounding a crown, so that the cyst remains within the cervical third. When these teeth are extracted without previous diagnosis, the cyst could become residual. In all dentigerous cyst, the microscopic features must be determined, since some reports mention their eventual transformation in an ameloblastoma or, even worse, in a squamous-cell carcinoma.

Adolescent

Age-standardized incidence rates of ameloblastoma and dentigerous cyst on the Witwatersrand, South Africa.

Although a great deal is known about the incidence of cancer, including oral cancer, no such study has been done on odontogenic tumors and jaw cysts. There are therefore no standardized data which would allow for comparative incidences in different countries and between different groups. In the present study, cases of ameloblastomas and dentigerous cysts derived from the records of all the hospital pathology departments and private pathology practices on the Witwatersrand, were recorded for the 10-year period 1965--1974. The population at risk (1970 census) was 974,390 Whites and 1,567,280 Blacks. The annual incidence rates, standardized against the standard world population, for ameloblastomas per million population are 1.96, 1.20, 0.18 and 0.44 for Black males, females and White males, females, respectively. The equivalent four figures for dentigerous cysts are 1.18, 1.22, 9.92 and 7.26. These figures show that ameloblastoma is very much more common in Blacks than Whites in the population at risk. Conversely, dentigerous cysts are much more common in Whites. This makes it unlikely that dentigerous cysts predispose to ameloblastoma formation. These epidemiologic observations give rise to speculation as to whether some component of the South African Black diet or other environmental substance might possibly be an etiologic factor in ameloblastoma.

Ameloblastoma

Dentigerous cyst with oro-antral fistula.

A dentigerous cyst of the upper jaw is a common disease, forming 3 per cent of all alveolar cysts. However, its association with an oro-antral fistula is extremely rare and only a few cases have been reported so far.

Adult

Dentigerous cysts of the maxilla.

Four cases of dentigerous cysts of the maxilla are recorded representing the three known types, namely: central, and multiple. The etiological theories are reviewed and treatment described.

Adolescent

[Epithelial remnants in the capsule of dentigerous cysts].

The authors studied 15 cases of dentigerous cysts presenting epithelial remnants in their capsule. Epithelial proliferation, mineralizations and squamous metaplasia and ameloblastomathoid differentiation were observed and analysed in relation to aging and localization. Neoplasic potentiality of the epithelial remnants were discussed and a new denomination were suggested to those lesions that presented ameloblastomathoid differentiation.

Adolescent

In vitro growth characteristics of human odontogenic keratocysts and dentigerous cysts.

Using an in vitro system, the growth characteristics and enzyme histochemical properties of 3 odontogenic keratocysts and 3 dentigerous cysts were studied. It was found that the epithelial cells of the keratocysts but not of the dentigerous cysts grew in vitro. Furthermore, the epithelial-like cells of the keratocysts showed the same activities of acid phosphatase and NADH-diaphorase in vitro as earlier described in vivo. These enzymatic activities were increased in epithelial-like cells close to proliferating fibroblast-like cells, indicating a close relationship between these two cell types. The results are discussed in the light of the known clinical behaviour of the keratocyst and certain conclusions are also drawn concerning the suggested neoplastic potential of the keratocyst.

Adult

Dentigerous cyst in a dog.

An infrequently occurring tumor-like lesion arising from the cellular components of the developing dental follicle is the dentigerous cyst. These odontogenic cysts have classic clinical and radiographic findings. The cysts are locally invasive and aggressive and require prompt surgical management. This case describes the diagnosis and surgical treatment of a dentigerous cyst in the mandible of a dog.

Animals

Surgical exposure and orthodontic alignment of an unerupted primary maxillary second molar impacted by an odontoma and a dentigerous cyst: a case report.

This report describes the surgical and orthodontic management of a 3-year old girl with an unerupted primary maxillary second molar impacted by an odontoma and a dentigerous cyst. Following surgical removal of the odontoma and dentigerous cyst, further surgical intervention and orthodontic traction were required to bring the primary maxillary second molar into correct occlusion with resultant proper functioning and good periodontal health.

Child, Preschool