Multiple teeth in a single dentigerous cyst follicle: A perplexity
A 40-year-old female reported at our center with the complaint of swelling in the right cheek and palate since 7–8 months which was gradually increasing in size.\nExtraoral examination revealed right maxillary expansion. The swelling had displaced the lateral nasal wall and the nasal floor. Intraorally, the swelling had extended onto the maxillary alveolar process and adjoining right palatal region extending up to midline. The patient did not report of any pain or paresthesia. Except for the facial asymmetry, physical examination was unremarkable, and routine laboratory tests were within normal limits.\nLateral skull radiograph showed a large radiolucent region occupying the whole maxillary sinus region with thinning of the maxillary walls and elevation of the orbital floor. The right permanent maxillary canine was displaced to the osteo meatal complex and the permanent premolar to the right nasal wall []. Computed tomography (CT) scan-PNS showed a large expansile bone lesion of 3.5 × 4.4 cm dimension in the right maxilla obliterating the right maxillary antrum and involving the right alveolar margin with an unerupted tooth visible in the osteo meatal complex and a second unerupted tooth in lateral nasal wall in different coronal sections of CT, suggestive of dentigerous cyst associated with two teeth [Figures and ].\nA provisional diagnosis of dentigerous cyst was made and the patient was operated under general anaesthesia by the Caldwell-Luc approach. The cyst was enucleated completely and both the teeth were removed, and the lining epithelium was found attached to the crown of both the teeth [].\nOn histopathological examination, a thin fibrous wall lined by nonkeratinized stratified squamous epithelium and connective tissue with inflammatory cell infiltrate was seen. The clinical and histological findings were consistent with the diagnosis of dentigerous cyst.\nPostoperatively, the facial and palatal swelling subsided gradually and the patient has been asymptomatic over a 1-year follow-up period.