Dentigerous cyst

Case contribution: Dr Radhiana Hassan


  • A 73 years old man
  • Underlying hypertension on medication
  • Presented with recurrent right facial pain
  • Had been on several courses of antibiotic
  • Clinical examination shows minimal swelling at right mandibular region which is non-tender on deep palpation. Good mouth opening.
  • Diagnosis of infected dentigerous cyst with impacted tooth 48
  • Operation done: cyst enucleation and surgical removal of tooth 48 under GA

Orthopantomogram findings:

  • A well-defined lucent area is seen at right mandible
  • It is ovoid in shape with sclerotic border
  • It is seen surrounding partially erupted root of third molar tooth
  • There is no fluid level within the lesion
  • No other lesion of visualized bones.

HPE findings:

  • Macroscopy: specimen labelled as tissue surrounding root 48
  • Microscopy: Sections show fibrous connective tissue of variable maturity lined in part by degenerated non-keratinising stratified squamous epithelium, which demonstrate arcading pattern in areas. There is a diffuse infiltration of mixed acute and chronic inflammatory cells. An area containing pool of haemorrhage also present. Trabeculae of woven and lamellar bones also observed.
  • Interpretation: Consistent with dentigerous cyst and inflamed mucosa


  • Dentigerous cyst is also known as follicular cyst
  • It is the most common type of non-inflammatory odontogenic cyst and the most common cause of pericoronal lucency associated with impacted tooth.
  • Most dentigerous cyst manifest in adolescent and young adult
  • It is often found around the crown of an unerupted mandibular third molar tooth
  • It can expand asymptomatically and potential to displace or resorb adjacent teeth or bone
  • At radiography it appears as well-defined, round or ovoid lucent lesions around the crowns of unerupted teeth, usually third molar. Other location include maxillary third molar, maxillary canine and mandibular second premolar.
  • The root of the involved tooth are often outside the lesion and located in mandibular bone.
  • It can vary in size from 2 cm or larger and may cause mandibular expansion
  • Treatment include extraction of associated tooth and removal of the entire cyst.
Author: radhianahassan