cyts and tumors:

The enamel organ is an

epithelial structure that is derived from
oral ectoderm. The dental follicle and dental papilla are considered ectomesench
ymal in nature because they are in part
derived from neural crest cells
The enamel organ has four types of
epithelium.
.. inner enamel epithelium
.. stratum intermedium
..stellate reticulum, followed by the outer enamel epithelium
Contact with the enamel organ epithelium
induces the dental papilla to make odontoblasts that form dentin
Following the initial formation of the
crown, a thin layer of the enamel organ
epithelium known as Hertwig s root
sheath proliferates apically to provide the
stimulus for odontoblastic differentiation
in the root portion of the developing
tooth. This epithelial extension later
becomes fragmented but leaves behind
small nests of epithelial cells known as
rests of Malassez in the periodontal ligament space.
However, if fluid accumulates
between the reduced enamel epithelium
and the crown of the tooth before tooth
eruption, a cyst is formed that is known as
a dentigerous or follicular cyst
With rare exceptions, epithelium-lined
cysts in bone are seen only in the jaws
developmental cysts are of
unknown origin; however, they do not
seem to be the result of an inflammatory
reaction. Inflammatory cysts, on the other
hand, are the result of inflammation
Dentigerous Cyst
commonly mandibular third molars.
Other common associations are with maxillary third molars, maxillary canines, an
d
mandibular second premolars.2
They may
also occur around supernumerary teeth
and in association with odontomas; however, they are only rarely associated with
primary teeth.
2,
in 10-30yrs
m>f
white>black
asyptomatic
3 types:
central
lateral

circumferential
d/d : dental follicle (h/p)
frozen-section analysis
In the
noninflamed dentigerous cyst, a thin epithelial lining may be present with the f
ibrous
connective tissue wall loosely arranged (Figure 30-4). In the inflamed dentigero
us cyst,
the epithelium commonly demonstrates
hyperplastic rete ridges, and the fibrous cyst
wall shows an inflammatory infiltrate
treated with enucleation of
the cyst
Large dentigerous cysts may be treated
with marsupialization (Figure 30-6) when
enucleation and curettage might otherwise
result in neurosensory dysfunction or predispose the patient to an increased cha
nce
of pathologic fracture.
Support of this statement
stems from the occasional formation of a
squamous cell carcinoma, mucoepidermoid carcinoma, or ameloblastoma from
or in association with a dentigerous cyst
okc: