World Journal of Dentistry

Register      Login

VOLUME 9 , ISSUE 5 ( September-October, 2018 ) > List of Articles

CASE REPORT

An Unusual Multicystic Case in a Non-syndromic Patient: A Case Report

Briguglio Francesco, Briguglio Roberto, Falcomatà Domenico

Keywords : Enucleation, Follicular cysts, Multicistic patient, Radicular cyst

Citation Information : Francesco B, Roberto B, Domenico F. An Unusual Multicystic Case in a Non-syndromic Patient: A Case Report. World J Dent 2018; 9 (5):423-429.

DOI: 10.5005/jp-journals-10015-1574

License: CC BY-NC 4.0

Published Online: 01-10-2018

Copyright Statement:  Copyright © 2018; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim: The aim of the article is to describe an unusual case of a non-syndromic patient affected by three follicular cysts in the mandible and then by an inflammatory cyst. Furthermore, we describe two different surgical approaches that we have used to manage this case: marsupialization and enucleation. Background: Dentigerous cysts are usually solitary cyst, the presence of multiple cysts is often combined with systemic diseases such as mucopolysaccharidosis, cleidocranial dysplasia, and basal cell nevus syndrome. They are the second cysts in order of frequency. Because of the lack of symptoms, their diagnosis is frequently radiological, and it can be suspected by the failure of tooth eruption. Case description: Two bilateral cysts of the third lower molars and radicular cyst of the right second lower molar were treated. An excisional therapy for the two dentigerous neoformations was performed. While, as a function of the remarkable dimensions which characterized the lesion, a conservative approach by marsupialization for 8 months before, and excision after, were chosen to solve the radicular inflammatory cyst. To preserve the patency of the cystic cavity, an acrylic obturator was used. Conclusion: In t he c ase of multiple d entigerous c ysts, a deepen clinical and systematic examination should be done to rule out any associated syndrome. Nowadays in literature, there is not a single and significant orientation based on the results obtained from the various techniques, but this case report shows that it is possible to achieve the expected therapeutic success even if in the same patient. Clinical significance: The case that we have described allows us to observe how a correct study of the lesions allows us to have a more accurate, safe and predictable therapeutic approach that lasts in time.


PDF Share
  1. Weber AL. Imaging of the cysts and odontogenic tumors of the jaw. Definition and classification. Radiol Clin North Am. 1993 Jan;31(1):101-120.
  2. O'Neil DW, Mosby EL, Lowe JW. Bilateral mandibular dentigerous cysts in a five-year-old child: report of case. ASDC J Dent Child 1989 Sep-Oct;56:382-384.
  3. Shafer H, Levy. Cyst and tumors of odontogenic origin in Shafers textbook of oral pathology; pp. 358-361. 5th ed. New Delhi: Elsevier India; 2007.
  4. Roberts MW, Barton NW, Constantopoulos G, Butler DP, Donahue AH. Occurrence of multiple dentigerous cysts in a patient with the Maroteaux-Lamy syndrome (mucopolysaccharidosis, type VI). Oral surgery, oral medicine, oral pathology. 1984 Aug 1;58(2):169-75.
  5. Johnson NR, Gannon OM, Savage NW, Batstone MD. Frequency of odontogenic cysts and tumors: a systematic review. Journal of investigative and clinical dentistry. 2014 Feb;5(1):9-14.
  6. Myers PB. Bilateral dentigerous cysts of the mandible. Br Dent J 1943;74:67-68.
  7. Henefer EP. Bilateral dentigerous cysts of the maxilla. Report of a case. Oral Surg Oral Med Oral Pathol 1964 Mar;17:296-298.
  8. Stanback JS. The management of bilateral cysts of the mandible. Oral Surg Oral Med Oral Pathol 1970 Nov;30:587-591.
  9. Callaghan JH. Bilateral impaction of lower third molars in association with bilateral dentigerous cyst formation. A case report. Glasg Dent J 1973 Spring;4:36-38.
  10. Burton DJ, Scheffer RB. Serratia infection in a patient with bilateral subcondylar impacted third molars and associated dentigerous cysts: report of case. J Oral Surg 1980 Feb;38:135-138.
  11. Swerdloff M, Alexander SA, Ceen RF, Ferguson FS. Bilateral mandibular dentigerous cysts in a seven-year-old child. J Pedod 1980 Fall;5:77-84.
  12. Crinzi RA. Bilateral dentigerous cysts of the mandible. Oral Surg Oral Med Oral Pathol 1982 Sep;54:367.
  13. McDonnell DG. Bilateral dentigerous cysts. A case history. J Ir Dent Assoc 1988 Jan;34:63.
  14. Eidinger GB. Bilateral dentigerous cysts in the child patient. Report of a case and review of the literature. Univ Tor Dent J 1989 Spring;2:20-23.
  15. Banderas JA, Gonzalez M, Ramirez F, Arroyo A. Bilateral mucous cell containing dentigerous cysts of mandibular third molars: report of an unusual case. Arch Med Res 1996 Autumn;27:327-329.
  16. Sands T, Tocchio C. Multiple dentigerous cysts in a child. Oral Health 1998 May;88:27-29.
  17. De Biase A, Ottolenghi L, Polimeni A, Benvenuto A, Lubrano R, Magliocca FM. Bilateral mandibular cysts associated with cyclosporine use: a case report. Pediatr Nephrol 2001 Dec;16:993-995.
  18. Batra P, Roychoudhury A, Balakrishan P, Parkash H. Bilateral dentigerous cyst associated with polymorphism in chromosome 1qh þ. J Clin Pediatr Dent 2004 Winter;28:177-181.
  19. Ko KS, Dover DG, Jordan RC. Bilateral dentigerous cysts – Report of an unusual case and review of the literature. J Can Dent Assoc 1999 Jan;65:49-51.
  20. Shah N, Thuau H, Beale I. Spontaneous regression of bilateral dentigerous cysts associated with impacted mandibular third molars. Br Dent J. 2002 Jan;192:75-76.
  21. Yamalik K, Bozkaya S, Erkmen E, Baris E. Nonsyndromic bilateral mandibular dentigerous cysts: Report of a rare case. Turkiye Klinikleri J Dent Sci. 2007;13:129-134.
  22. Imada TS, Neto VT, Bernini GF, Silva Santos PS, Rubira-Bullen IR, Bravo-Calderòn D, Unusual bilateral dentigerous cysts in a nonsyndromic patient assessed by cone beam computed tomography. Contemp Clin Dent. 2014 Apr;5(2):240-242.
  23. Fregnani ER, Perez DE, de Carvalho PA, Alves FA. Metachronous bilateral dentigerous cysts associated with permanent first molars. J Dent Child (Chic) 2008 May-Aug;75:197-200.
  24. Sergio EV, Maria DP, Sergio EN. Bilateral dentigerous cyst in a non syndromic patient: Case report and literature review. Am Acad Pediatr Denty. 2009 Jan;76:92-96.
  25. Ustuner E, Fitoz S, Atasoy C, Erden I, Akyar S. Bilateral maxillary dentigerous cysts: a case report. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2003 May 1;95(5):632-635.
  26. Freitas DQ, Tempest LM, Sicoli E, Lopes–Neto FC. Bilateral dentigerous cyst: Review of literature and report of unusual case. Dento Maxillofac Radiol. 2006 Nov;35:64-68.
  27. Norris L, Piccoli P, Papageorge MB. Multiple dentigerous cysts of the maxilla and the mandible:report of a case. J Oral Maxillofac Surg 1987 Aug;45:694-697.
  28. Daley TD, Pringle GA. Relative incidence of odontogenic tumors and oral and jaw cysts in a Canadian population. Oral Sur Oral Med Oral Pathol 1994 Mar;77:276-80.
  29. Neville BW, Damm DD, Allen CM, Bonquot JE. 2nd ed. Philadelphia. P.A: W.B. Saunders; 2005.Odontogenic cysts and tumors. Oral and Maxillofacial pathology; pp. 591-592.
  30. Enislidis G, Focka N, Sulzbacher I, Ewers R. Conservative treatment of large cystic lesions of the mandible: a prospective study of the effect of decompression. Br J Oral Maxillofac Surg 2004 Aug;42:546-550.
  31. Sakkas N, Schoen R, Schulze D, Otten JE, Schmelzeisen R. Obturator after marsupialization of a recurrence of a radicular cyst of the mandible. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2007 Jan 1; 103(1):e16-18.
  32. Delilbasi C, Yuzbasioglu E, Aydin K. Complete healing of radicular cysts only by marsupialization. J Clin Case Rep 2:199.
  33. Riachi F and Tabarani C. Effective Management of Large Radicular Cysts Using Surgical Enucleation vs. Marsupialization Two Cases Report. Int Arab J Dent 2010 Jan;(1)1.
  34. Delbem ACB, Cunha RF, Vieira AEM, Pugliesi DMC. Conservative treatment of a radicular cyst in a 5-year-old child: a case report. Int J Paediatr Dent 2003 Nov;13:447-450.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.