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| LETTER TO EDITOR |
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| Year : 2012 | Volume
: 1
| Issue : 3 | Page : 210 |
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Diagnostic dilemma for both radiologist and pathologist-dilated follicles or small dentigerous cyst
Harkanwal P Singh1, Prince Kumar2, Ruchika Bansal3, Suresh Yadav4
1 Department of Oral Pathology and Microbiology, Swami Devi Dyal Hospital and Dental College, Barwala, Panchkula (Haryana), India
2 Department of Prosthodontics, Shree Bankey Bihari Dental College and Research Centre, Ghaziabad, India
3 Department of Conservative Dentistry and Endodontics, Swami Devi Dyal Hospital and Dental College, Barwala, Panchkula (Haryana), India
4 Department of Oral and Maxillofacial Surgery, Kalka Dental College, Meerut, Uttar Pradesh, India
| Date of Web Publication | 26-Dec-2012 |
Correspondence Address:
Harkanwal P Singh
Department of Oral Pathology and Microbiology, Swami Devi Dyal Hospital and Dental College, Barwala, Panchkula (Haryana)
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/2278-344X.105094
How to cite this article:
Singh HP, Kumar P, Bansal R, Yadav S. Diagnostic dilemma for both radiologist and pathologist-dilated follicles or small dentigerous cyst. Int J Health Allied Sci 2012;1:210 |
How to cite this URL:
Singh HP, Kumar P, Bansal R, Yadav S. Diagnostic dilemma for both radiologist and pathologist-dilated follicles or small dentigerous cyst. Int J Health Allied Sci [serial online] 2012 [cited 2023 Mar 30];1:210. Available from: https://www.ijhas.in/text.asp?2012/1/3/210/105094 |
Sir,
Extensive overlap in the age and site predilection of the dentigerous cyst and the dental follicle raises the question of accurate differentiation between the two. [1] Some unerupted teeth have a slightly dilated follicle in the pre-eruptive phase. This does not signify a cyst, nor even necessarily a potential cyst unless the pericoronal width is at least 3-4 mm. [1],[2],[3] Daley and Wysocki have pointed out that it can be difficult to distinguish between a small dentigerous cyst and a large dental follicle despite the availability of both radiographical and histological information. [1] Damante and Fleury, in order to differentiate small dentigerous from paradental cysts, analyzed the relationship between the radiographically measured width of the pericoronal space and the microscopic features of the follicle. Their sample comprised 130 unerupted teeth and 35 partially erupted teeth. The widths of the pericoronal spaces ranged from 0.1 to 5.6 mm. The most frequently observed lining of the follicles was a reduced enamel epithelium in 68.4% of unerupted teeth and a hyperplastic stratified squamous epithelium in association with the partially erupted teeth in 68.5%. Inflammation was present in 36.1% of the unerupted teeth and in 82.8% of the partially erupted group. There was a statistically significant association between the presence of stratified squamous epithelium and pericoronal space enlargement for unerupted teeth. A trend was noted in the association between inflammation and enlargements of the pericoronal spaces in partially erupted teeth and possibly in unerupted teeth, but there was no measurable statistical significance. [2] At present, the only reliable way to differentiate a small dentigerous cyst from a large dental follicle is to perform the surgical procedure. A true cyst will exhibit a fluid-filled cavity that allows the surgeon to easily separate the dentigerous cyst from at least a portion of the enamel surface of the impacted tooth. Even this surgical difference may not be useful in some cases, especially in those that involve full bony impactions or horizontal impactions, in which the surgical procedure may not readily permit such an examination. [1],[3] So, we pointed out the lack of universal criteria for diagnosis of dentigerous cyst and dental follicle. Despite of these facts, the literature continues to report misdiagnoses of dentigerous cyst. Differentiation between such lesions is of academic interest only since the surgical treatment is same for follicles and small dentigerous cysts. [4],[5]
| References | |  |
| 1. | Daley TD, Wysocki GP. The small dentigerous cyst. A diagnostic dilemma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1995;79:77-81. 
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| 2. | Damante JH, Fleury RN. A contribution to the diagnosis of the small dentigerius cyst or the paradental cyst. Pesqui Odontol Bras 2001;15:238-46.
[PUBMED] |
| 3. | Damante JH, Fleury RN. A contribution to the diagnosis of the small dentigerous cyst or the paradental cyst. Pesqui Odontol Bras 2001;15:238-46.
[PUBMED] |
| 4. | Fukuta Y, Totsuka M, Takeda Y, Yamamoto H. Pathological study of the hyperplastic dental follicle. J Nihon Univ Sch Dent 1991;33:166-73.
[PUBMED] |
| 5. | Kim J, Ellis GL. Dental follicular tissue misinterpretation as odontogenic tumors. J Oral Maxillofac Surg 1993;51:767-8.
[PUBMED] |
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