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We present a case of a dentigerous cyst associated with an unerupted premolar tooth, and its surgical management in a 4-year-old child. Of note, 8 months prior to presentation, the patient was seen for extraction of multiple primary teeth under general anaesthesia. At the time of extraction, there were no signs of extra- or intra-oral mandibular swellings. Dentigerous cysts are one of the most common paediatric intra-osseous lesions. This case highlights the importance of taking a thorough dental history and the benefit of a multidisciplinary approach. This report also demonstrates the surgical management of this lesion, which included surgical excisional biopsy under general anaesthesia.
CPD/Clinical Relevance: The reader should consider dentigerous cysts as a differential diagnosis in paediatric patients who present with dental swellings.
Article
Dentigerous cysts are one of the most common paediatric jaw cysts.1,2,3 They are characterized by their attachment to the cemento-enamel junction of an unerupted tooth. Dentigerous cysts can be asymptomatic and are often diagnosed through routine radiographic examination. However, diagnosis can also be made following acute exacerbation with infection.
A 4-year-old boy attended the paediatric dental emergency clinic with his father, who was concerned about a left-sided facial swelling that had been present for at least 1 month.
He reported a history of nocturnal pain. The patient had been prescribed oral antibiotics by his local dentist, which made no improvement in his symptoms. The patient's medical history was unremarkable.
Of note, 8 months prior to presentation, the patient had undergone dental treatment under general anaesthesia, which included multiple extractions of primary teeth and notably, extraction of the lower left first primary molar (LLD). There were no signs of intra- or extra-oral mandibular swelling at the time of extraction. Radiographs taken prior to the general anaesthetic revealed no peri-apical pathology or radiolucency in the region of the LLD (Figure 1).
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