Radiology Teaching Files > Case 22240477

Contributed by: bala chandiran, Radiologist, govt.general hospital,pondicherry, India.
Patient: 23 year old male
History: A twenty three old male was referred for evaluation of maxillary region swelling.

Fig. 1

Fig. 2

Fig. 3

Fig. 4
Findings: CT scan in axial and coronal views show a well defined 3.4 x3.2 cm. unilocular cyst from the right side ,in the region of upper canine tooth.The cyst was expansile,with an unerupted tooth at its base.The cyst contents were homogenous with a CT value + 36 H.U.
Diagnosis: Maxillary dentigerous cyst
Discussion: The second most common odontogenic cyst is the dentigerous cyst, which develops within the normal dental follicle that surrounds an unerupted tooth.Dentigerous cysts are the most prevalent type of odontogenic cysts attached at the cemento-enamel junction.They are most commonly seen in mandible third molar and in maxillary canine.Males are more commonly affected.,in the third decade.A dentigerous cyst is an odontogenic cyst - thought to be of developmental origin - associated with the crown of an unerupted (or partially erupted) tooth. The cyst cavity is lined by epithelial cells derived from the reduced enamel epithelium of the tooth forming organ. Regarding its pathogenesis, it has been suggested that the pressure exerted by an erupting tooth on the follicle may obstruct venous flow inducing accumulation of exudate between the reduced enamel epithelium and the tooth crown. The dentigerous cyst is not thought to be neoplastic. It most frequently is found in areas where unerupted teeth are found: mandibular third molars, maxillary third molars, and maxillary canines, in decreasing order of frequency. These cysts can grow very large and can move teeth, but, more commonly, they are relatively small. Most dentigerous cysts are asymptomatic, and their discovery is usually an incidental finding on radiography The usual radiographic appearance is that of a well-demarcated radiolucent lesion attached at an acute angle to the cervical area of an unerupted tooth. The border of the lesion may be radiopaque. The radiographic differentiation between a dentigerous cyst and a normal dental follicle is based merely on size. Radiographically, a dentigerous cyst should always be differentiated from a normal dental follicle.
References: 1.. D. K. Isser, S. Das,Maxillary Dentigerous cyst in a young boy Indian Journal of Otolaryngology and Head and Neck Surgery Vol. 54 No. 1, January - March 2002 2 Moon Hee Han, Kee Hyun Chang, Chul Hee Lee, Cystic Expansile Masses of the Maxilla: DifferentialDiagnosis with CT and MR, AJNR Am J Neuroradiol 16:333–338, February 1995
No comments posted.
Additional Details:

Case Number: 22240477Last Updated: 12-29-2008
Anatomy: Other   Pathology: Benign Mass, Cyst
Modality: CTAccess Level: Readable by all users
Keywords: maxillary dentigerous cyst

The reader is fully responsible for confirming the accuracy of this content.
Text and images may be copyrighted by the case author or institution.
You can help keep MyPACS tidy: if you notice a case which is not useful (e.g. a test case) or inaccurate, please contact us.