Developmental Cysts

Dentigerous cyst

It is a developmental odontogenic epithelialized jaw

cyst, which encloses the crown and attached to the
neck (cemento-enamel junction )of an un erupted
tooth.

 Making up about 20% of all epithelium lined

cysts of the jaws.
 Dentigerous cyst

Pathogenesis:-
Derived from reduced enamel epithelium that
surround the crown of an un erupted tooth by
separation of the reduced enamel epithelium
from crown surface creating space for fluid
accumulation around crown of the tooth .
 Dentigerous cyst

Clinical features:-
 Most often they involve mandibular 3rd molars
 other relative side site include
 maxillary canines
 maxillary 3rd molar
 mandibular 2nd premolars.
 Dentigerous cyst

 Discovered frequently in patients between 10-

30 years old.
 Slight male predilection.
 Asymptomatic and discovered only on routine
radiographic examination or when films are
taken to determine the reason for the failure of
a tooth to erupt.
 Dentigerous cyst

 Dentigerous cyst may become infected and

associated with pain and swelling.

Radiographically:-
 It shows unilocular radiolucent area that
associated with crown of an un erupted tooth.
 Dentigerous cyst

Histopathological features:-
 Non inflammed dentigerous cyst:
 The fibrous C.T wall is loosely arranged and contain
considerable amount of glycosaminoglycan ground
substance.
 Small islands or cords of inactive odontogenic
epithelial rest may present in the fibrous wall.
 The epithelial lining consists of 2-4 layers of flattened
non keratinized cells .
 Epithelium and c.t interface is flat.
 Dentigerous cyst

 Inflammed dentigerous cyst:-

 The fibrous wall is more collagenized with
variable infilteration of chronic inflammatory
cells.
 The epithelial lining may show varying amount of
hyperplasia with development of rete ridges.

 Focal areas of mucous cells may be found in the

epithelial lining of dentigerous cyst.
 Treatment
 Enucleation of the cyst together with removal
of the un erupted tooth.
 Eruption cyst(eruption hematoma)

 It is the soft tissue analogue of the dentigerous

cyst.
 The cyst derived from reduced enamel
epithelium as a result of separation of the
reduced enamel epithelium around the crown
of an erupting tooth that within the soft tissues
overlying the alveolar bone.
 Eruption cyst

Clinical features
Eruption cyst appears as soft ,often translucent
swelling in the gingival mucosa overlying the
crown of an erupting deciduous or permanent
tooth.
Most common in children younger than 10 years
old , most commonly associated with deciduous
mandibular incisors.
 Eruption cyst

Histopathological features:-
The same histopathologic feature of dentigerous
cyst .
Intact eruption cyst seldom submitted to oral
pathology laboratory ,and most example consist of
the excised roof of the cyst and this consists of :
 oral epithelium on the superior aspect
 underlying lamina propria shows inflammatory
cell infiltrate
 the deeper portion shows thin layer of non
keratinized squamous epithelium.
 Treatment
 May not be required because the cyst rupture
spontaneously ,permitting the tooth to erupt, if
this does not occur simple excision of the roof
may be required.