Clinicopathologic Profile of Dentigerous Cyst in North Karnataka Region of India: A 20 Years Review

Abstract

Introduction: The Dentigerous Cyst (DC) is the second most common odontogenic cyst, accounting to approximately 20.3% of all epithelium-lined cysts of the jaws with distinct clinico-pathologic features. However, comprehensive data regarding DC alone is sparse in the literature and none exist in Indian population. Aim: To determine the distribution of histologically confirmed DCs diagnosed over a period of 20 years in an Indian population according to age, gender and affected site as well as to compare these data with previously reported studies in literature from various countries. Materials and Methods: Biopsy Services were searched from 1989 to 2009 which retrieved 68 histologically confirmed DCs from 6400 patients. These cases were retrospectively analysed for incidence, age, gender, site distribution, clinical presentation and histopathological features. Results: Dentigerous cyst accounted for 9.93% amongst odontogenic cysts with a mean age of 22.76 years and a peak incidence in the second decade of life. It demonstrated a male predilection with predominance for the maxilla (58.82%) especially in the anterior region. They were mostly associated with impacted teeth especially third molar and maxillary canine and even with impacted supernumerary teeth. Most of the cases presented with an asymptomatic swelling (43/68) and were found accidentally during radiographic examination as unilocular radiolucency surrounding the crown of an unerupted tooth. DCs were also seen associated with other odontogenic cysts or tumours. Additionally, there were nine cases which clinically presented as DCs, but on histological examination revealed an associated odontogenic tumour either an Adenomatoid Odontogenic Tumour (AOT) or ameloblastoma originating from DC. Conclusion: Among the odontogenic cysts, DC was the third most common cyst following radicular cyst and Odontogenic Keratocyst (OKC). Rare findings noticed were association of DC with supernumerary teeth and AOT arising from DC lining (9 cases), apart from classic findings reported in literature. Additional epidemiological research is warranted to understand the frequency and variations in the clinicopathologic presentation in different populations.

Keywords

• ameloblastoma
• oral cavity
• supernumerary teeth