Odontogenic Cysts
Dentigerous Cyst
aka Follicular cyst
Odontogenic developmental cyst that surrounds the crown of an unerupted tooth and is attached at the CEJ.
§ overviewOverview
Odontogenic developmental cyst that surrounds the crown of an unerupted tooth and is attached at the CEJ.
§ epidemiologyEpidemiology
Second most common odontogenic cyst. Peak 20–40 years. Mandibular third molars and maxillary canines most affected.
§ pathogenesisPathogenesis
Fluid accumulates between reduced enamel epithelium and enamel of an unerupted tooth.
§ clinicalClinical Features
- 01Often asymptomatic — incidental finding
- 02Painless bony expansion when large
- 03Displacement / resorption of adjacent teeth
§ differentialDifferential Diagnosis
- 01OKC
- 02Unicystic ameloblastoma
- 03Adenomatoid odontogenic tumour
- 04Hyperplastic dental follicle (< 4 mm)
§ histopathHistopathology
- 012–4 cell thick non-keratinised stratified squamous epithelium
- 02Fibrous CT wall with occasional inflammatory infiltrate
§ radiographicRadiographic Features
- 01Well-defined unilocular corticated radiolucency around the crown of unerupted tooth
- 02Attachment at CEJ
- 03Central (surrounds crown), lateral, or circumferential variants
§ cbctCBCT Findings
- 013D relation to IAN canal and adjacent roots
§ treatmentTreatment
- 01Enucleation + extraction of associated tooth
- 02Marsupialisation for very large cysts / young patients to preserve tooth
§ complicationsComplications
- 01Recurrence rare
- 02Neoplastic transformation to ameloblastoma, mucoepidermoid carcinoma, or SCC (rare)
§ prognosisPrognosis
Excellent after complete enucleation.
§ pearlsClinical Pearls
- 01Follicular space > 4 mm on OPG is suspicious for dentigerous cyst.
§ mcqsMCQs — Assessment (1)
Question 1
Attachment of dentigerous cyst is at:
Draft — pending faculty review. Educational use only; verify against current guidelines and primary sources before clinical application.