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Removal of impacted ectopic third molar associated with dentigerous cyst

Eduardo Cekaunaskas Kalil, Thays Almeida Alfaya, Carolina Carvalho Bortoletto, Kristianne Porta Santos Fernandes, Raquel Agnelli Mesquita-Ferrari, Sandra Kalil Bussadori

Med Sci Tech 2013; 54:99-102

DOI: 10.12659/MST.889365


Background:   A dentigerous cyst originates from the separation of the follicle of the crown of an impacted tooth and is considered the most prevalent type of odontogenic cyst.
            Case Report:  This paper describes the clinical case of a 50-year-old female patient who visited a private dental office complaining of an increase in volume in the region of the left temporomandibular joint and pain upon chewing. The physical exam revealed an increase in volume and pain upon intra-oral and extra-oral palpation in the region of the ramus and condyle of the left mandible. Tomography revealed an impacted third molar (tooth 38) in an inverted, ectopic position in the region of the mandibular notch, with a unilocular radiolucent image associated with the crown and rupture of the lingual bone cortex. The diagnostic hypotheses were dentigerous cyst, unilocular ameloblastoma, and odontogenic keratocyst. Treatment involved the removal of the affected tooth and enucleation of the lesion. Fragments of the lesion were sent for anatomopathological analysis, which confirmed the diagnosis of a dentigerous cyst.
            Conclusions:   The unusual ectopic position associated with a dentigerous cyst in a patient outside the age group usually associated with this type of cyst makes this a peculiar clinical occurrence. Anatomopathological analysis of the material collected and periodic follow-up are important aspects in such cases.

Keywords: Therapeutics, Tooth Eruption, Ectopic, Dentigerous Cyst

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