Dentigerous Cyst Involving the Maxillary Sinus

ABSTRACT

BACKGROUND AND OBJECTIVES: Dentigerous cysts arise from the reduced enamel epithelium and expand into the surrounding bone. They grow unnoticed to such extensive sizes as to occupy a considerable portion of the maxillary sinus. This study was designed to clarify the clinical, radiological and histopathological features of ten cases of the dentigerous cyst involving the maxillary sinus. MATERIALS AND METHODS: Medical records of ten patients, who were diagnosed with dentigerous cyst, were analyzed from June 1990 to May 2000 retrospectively. RESULTS: The greatest incidence of dentigerous cyst occurred between the ages of 10 and 30 years old (average age 29.6 years). Facial swelling and pain were the most common com-plaints, followed by oro-antral fistula, headache and facial numbness. CT scan of paranasal sinuses showed a slightly nonhomogeneous soft tissue density surrounded by an incomplete bony wall which occupied partially antral space. In the middle of the cyst, the isolated high density of unerupted tooth was seen. In the lining epithelium, the stratified squamous epitheliums were the most frequent. Six patients underwent cyst removal via Caldwell-Luc approach and four patients underwent cyst removal via intraoral approach. The postoperative course has been gone well without recurrence. CONCLUSIONS: The differential diagnosis and early detection of the dentigerous cyst in involving maxillary sinus are important. Rhinologist should be aware of this disease entity when encountered with patients presented with unilateral painful swelling of cheek.