Management of an Infected Giant Dentigerous Cyst Associated with Maxillary Third Molar

Abstract

Dentigerous cysts are the most frequent type of developmental cysts of the jaw and the second most frequent type of odontogenic cysts after radicular cysts. Dentigerous cysts are usually asymptomatic and discovered incidentally during routine radiographic examination. Therefore, they can grow to a massive size before they are diagnosed. In some cases, cysts can become infected and patients refer with pain or swelling like symptoms. The considered definitive treatment for dentigerous cysts is the enucleation of the cyst and the extraction of the associated tooth. The purpose of the current report is to present the treatment of a large infected dentigerous cyst associated with the maxillary third molar. A 71-year-old man referred to our oral and maxillofacial surgery department with a painful swelling in the left maxillary posterior site. Intraoral examination revealed a soft, diffused, cyst like swelling in the gingivobuccal sulcus. Panoramic radiography showed a relatively large, unilateral radiolucency extending from the left canine tooth to the left tuberosity area enveloping the impacted third molar. Cone beam computerized tomography showed a cystic lesion measuring 35 mm horizontally, 27 mm vertically and 30 mm sagittally with the palatal and buccal cortical bone expanded and destructed. The cyst was totally enucleated together with the impacted third molar and the patient recovered without complication.