Growing potential of Dentigerous cyst. Case report

Abstract

Introduction: The dentigerous or follicular cyst is an odontogenic cyst that frequently develops in relation to a not erupted tooth crown, with a greater percentage of incidence in the lower third molars. Its great potential growth leads to asymmetries, paresthesia, dental displacement, and even neoplastic transformation.  For this reason, the therapeutic behavior with regard to this problem is of great importance.
Objective: To show the treatment by enucleation of a mandibular dentigerous cyst of great proportions and elevated risk of mandibular fracture, followed in a single surgical time with a favorable evolution.
Case presentation: 45 years old male patient that came to Service of Maxillofacial Surgery presenting an increase in the volume of the left mandibular zone; the panoramic radiography showed an unilocular radiolucent area of a great size, which compromised the mandibular body from tooth 33 up to reaching 2/3 of the ascending branch, associated to a retained third molar displaced to the lower mandibular edge. There was reabsorption of the roots of the 34 and 35 teeth, too.  The patient was treated in a single surgical time with removals of the affected teeth, intermaxillary blocking with previous placement of Gunning splints, cyst enucleation by cervical approach, and exerecis of the associated tooth. The histopathological diagnosis showed a dentigerous cyst.  The patient presented no complications, and had a favorable evolution.
Conclusions: The dentigerous cysts can cause serious alterations when they are not diagnosed on time. The enucleation in a single surgical time is considered an election treatment to guarantee non-recurrence, whether all measures are taken to avoid trans and post-surgical complications.
Keywords:epithelial cysts, odontogentic dentigerous cysts, maxillary cysts, follicular cysts, retained teeth.