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Open AccessCase Report

Unusual Imaging Features of Dentigerous Cyst: A Case Report

1
Laboratory of Oral & Maxillofacial Pathology, Oral Medicine and Oral and Maxillofacial Pathology Unit, Division of Oral Maxillofacial Surgery, Department of Surgery, Geneva University Hospitals, University of Geneva, 1211 Geneva, Switzerland
2
Centre for Diagnosis and Treatment of Oral Diseases, Ribeirão Preto 14025-250, Brazil
*
Author to whom correspondence should be addressed.
Dent. J. 2019, 7(3), 76; https://doi.org/10.3390/dj7030076
Received: 26 March 2019 / Revised: 21 May 2019 / Accepted: 5 July 2019 / Published: 1 August 2019
(This article belongs to the Special Issue Pathogenesis of Periodontal Disease)
Dentigerous cysts (DC) are cystic lesions radiographically represented by a well-defined unilocular radiolucent area involving an impacted tooth crown. We present an unusual radiographic feature of dentigerous cyst related to the impacted mandibular right second molar, in a 16-year-old patient, which suggested an ameloblastoma or odontogenic keratocyst (OKC) because of its multilocular appearance seen on the panoramic radiography. A multi-slice computed tomography (MSCT), however, revealed a unilocular lesion without septations, with an attenuation coefficient from 3.9 to 22.9 HU suggesting a cystic lesion. Due to its extension, a marsupialization was performed together with the histopathological analysis of the fragment removed which suggested a dentigerous cyst. Nine months later, the lesion was reduced in size and then totally excised. The impacted mandibular right second molar was also extracted. Histopathological examination confirmed the diagnosis of a dentigerous cyst. One year later, the panoramic radiography showed a complete mandible bone healing. Large dentigerous cysts can sometimes suggest other more aggressive pathologies. Precise diagnosis is important to avoid mistakes since DC, OKC and ameloblastoma require different treatments. Histological examination is, therefore, essential to establish a definitive diagnosis. In our case, MSCT and the tissue attenuation coefficient analysis contributed to guide the diagnosis and management of the dentigerous cyst. View Full-Text
Keywords: dentigerous cyst; radiographic differential diagnosis; multislice computed tomography; hounsfield unit analysis dentigerous cyst; radiographic differential diagnosis; multislice computed tomography; hounsfield unit analysis
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Martinelli-Kläy, C.P.; Martinelli, C.R.; Martinelli, C.; Macedo, H.R.; Lombardi, T. Unusual Imaging Features of Dentigerous Cyst: A Case Report. Dent. J. 2019, 7, 76.

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