Case report
Nonsyndromic bilateral maxillary dentigerous cysts: Review of literature and report of an unusual case

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Abstract

Dentigerous cysts are benign odontogenic cysts that arise from the dental follicle of an unerupted or developing tooth. They are the second most common odontogenic cysts after radicular cysts. Multiple dentigerous cysts have been reported on occasion in association with syndromes such as cleidocranial dysplasia, mucopolysaccharidosis and basal cell nevus syndrome. We report the clinical and radiologic findings of bilateral maxillary dentigerous cysts in a nonsyndromic 10-year-old boy, a condition that, to our knowledge has only been reported twice. The importance of early diagnosis and management is highlighted.

Introduction

A dentigerous cyst is defined as an epithelial-lined developmental cavity arising from the enamel organ due to an alteration in the reduced enamel epithelium and enclosing the crown of an unerupted tooth at the cementoenamel junction [1], [2], [3]. Dentigerous cysts are the second most common odontogenic cysts after radicular cysts and account for approximately 24% of the jaw cysts [1], [2], [4], [7]. They usually present in the second or third decades of life and are rarely seen during childhood. These cysts are usually solitary [5] with multiple occurrences reported on occasion in association with syndromes such as cleidocranial dysplasia, mucopolysaccharidosis (type VI) and basal cell nevus syndrome [5], [6]. This case report presents the clinical and radiologic findings of bilateral maxillary dentigerous cysts in a nonsyndromic ten-year-old boy. A search of PubMed/Medline, using the key words, anterior, maxillary, dentigerous cyst, and bilateral was conducted and revealed only two instances of bilateral maxillary dentigerous cysts [7], [8].

Section snippets

Case report

A ten-year-old boy presented with a painless swelling in the maxillary anterior region. There was a history of a fall from a height, 5 months back while flying a kite with the loss of an upper tooth. General physical examination was unremarkable and the patient's growth and development was consistent with age. Intraoral examination revealed a firm swelling in the premaxillary region, distinctly pronounced on both sides of the midline more so on the left. No bruit or pulsation was observed.

Discussion

Dentigerous cysts are benign odontogenic cysts that arise from the dental follicle of an unerupted or developing tooth [9]. These involve impacted, unerupted permanent teeth, supernumerary teeth, odontomas, and, rarely, deciduous teeth. In 75% of the cases, they are located in the mandible [1], [7], [10]. The most frequently involved teeth are the mandibular third molars and maxillary canines [2], [7]. Peak incidence is in the second and third decades. Dentigerous cysts are usually painless but

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