Delayed eruption of a maxillary canine in an adolescent
14-year-old female
§Chief complaint
Baby canine still present at age 14
§Medical & dental history
- 01Fit and well
- 02Retained deciduous 63
- 03Orthodontic assessment in progress
§Clinical examination
- 01Retained 63 with no mobility; 23 not palpable buccally
- 02Slight palatal fullness in the 23 region
- 03Adjacent teeth vital, no discolouration
- 04No swelling or discharge
§ figuresFigures (3)
Fig. 1dentigerous jaw cyst in the right mandible around and impacted wisdom tooth
“JawCyst (with arrows)” · JawCyst.jpg: Coronation Dental Specialty Group [1] derivative work: Jbarta · CC BY 3.0 · Wikimedia Commons
Fig. 2dentigerous jaw cyst in the right mandible around and impacted wisdom tooth
“JawCyst (with arrows, cropped)” · JawCyst.jpg: Coronation Dental Specialty Group [1] derivative work: Jbarta and M · CC BY 3.0 · Wikimedia Commons
Verified open-access images only, reproduced for education under their stated licences · no AI-generated or illustrative artwork · Dentigerous Cyst figures pending faculty review.
§Differential diagnosis
§Final diagnosis
Dentigerous cyst associated with an impacted 23
AOT is the key mimic in this exact location and demographic; it typically shows fine snowflake calcifications and envelopes the root beyond the CEJ, whereas a dentigerous cyst attaches exactly at the CEJ and is entirely radiolucent.
§Investigations
- 01CBCT — pericoronal radiolucency 12 mm around the crown of 23, attachment at the CEJ, palatal position
- 02No calcification within the lesion
- 03Vitality testing of 22 and 24 — vital
§Treatment plan
- 01Marsupialisation of the cyst and exposure of 23
- 02Orthodontic traction to bring 23 into the arch
- 03Extraction of retained 63
§Surgical procedure
- 01Palatal window created and cyst lining marsupialised
- 02Gold chain bonded to 23 and orthodontic traction commenced at 3 weeks
§Histopathology report
Thin non-keratinised epithelial lining 2-4 cells thick with a fibromyxoid wall. Dentigerous cyst.
§Follow-up & outcome
- 0123 erupted into the arch over 14 months of traction
- 02Radiographic resolution of the lucency
- 03Tooth vital with good periodontal support
§Clinical pearls / learning points
- 01In an adolescent, treat the cyst in a way that preserves the tooth — marsupialisation plus traction beats enucleation with extraction.
- 02Radiopaque flecks in a pericoronal lesion in the anterior maxilla suggest AOT.
- 03Always confirm the attachment point at the CEJ on CBCT.
§ evidenceReferences & Evidence
Current Classification
WHO Classification of Head and Neck Tumours
5th Edition — Volume 9
WHO Classification of Tumours Editorial Board · 2022
The authoritative international classification of head and neck, odontogenic and salivary gland tumours. Current terminology on this site follows this edition.
Evidence summary
Highest level of evidence linked to this page: WHO / Official Classification.
- L1 · Classification — 3
- L4 · Research — 1
- L6 · Textbook — 3
1 linked source was published from 2024 onwards. Where guidance is limited or contested, rely on the higher-level sources above rather than this summary. Educational use only — not a substitute for clinical judgement.
Content last reviewed
September 2026
Evidence last reviewed
September 2026
Next scheduled review
September 2027
Review status
EVIDENCE REVIEWED
Search latest PubMed evidence
Last literature search: 7 September 2026
Current Classification
WHO Classification of Tumours Editorial Board. IARC / World Health Organization · 2022
The authoritative international classification of head and neck, odontogenic and salivary gland tumours. Current terminology on this site follows this edition.
Vered M, Wright JM. Head and neck pathology · 2022 · 16(1):63-75
Summary of odontogenic and maxillofacial bone tumour changes in the 5th edition WHO classification.
IARC / WHO. IARC · 2022
Continuously updated online edition of the WHO head and neck tumour classification.
Radiology References
Dunfee BL, Sakai O, Pistey R et al.. Radiographics : a review publication of the Radiological Society of North America, Inc · 2006 · 26(6):1751-68
Radiologic-pathologic correlation of benign and malignant odontogenic lesions of the jaws.
Histopathology References
Barnes L. CRC Press · 2008
Detailed histopathological reference for head and neck diagnostic criteria.
Textbook References
Neville BW, Damm DD, Allen CM et al.. Elsevier · 2024
Standard reference textbook of oral and maxillofacial pathology used throughout this atlas.
Rajendran R, Sivapathasundharam B. Elsevier · 2020
Undergraduate and postgraduate oral pathology textbook widely used in BDS and FCPS curricula.
Additional sources cited on this page
- Neville BW et al. Oral and Maxillofacial Pathology, 5th ed.
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