Spontaneous Regression of a Dentigerous Cyst in a Middle-aged Adult

Abstract

Follicular cysts associated with impacted teeth in adults usually increase in size or remain static. A case is presented in which a typical dentigerous cyst decreased in size without any subjective or objective evidence of spontaneous drainage.

Case Details

Personal Characteristics

63-year-old white woman, edentulous except for the impacted tooth

Clinical Characteristics

Distoangularly impacted lower right third molar with a pericoronal radiolucency, the border of which stood 4 to 5 millimeters away from the crown of the tooth. Significant diminution in size of the radiolucency, which now was bordered by a cortical rim of bone. The crown of the tooth was palpable through clinically normal gingiva posterior to the distal extension of the lower denture. No evidence of a fistula or scarring was noted. Upon surgical exploration, the crown of the tooth was found to be partially exposed through the bone, with the overlying follicular sac intact and normal in appearance.

Remission Characteristics

The patient recovered uneventfully and has shown complete bony fill and no evidence of pathosis as of april 1983.

Treatment & Mechanisms

Proposed Remission Mechanisms

The lesion decompressed spontaneously.

Clinical Treatment

Removal of a distoangularly impacted lower right third molar and its associated pericoronal cyst. The tooth and its pericoronal dentigerous cyst were easily removed.

Additional Notes

It is most unusual for a pericoronal radiolucent lesion to decrease in size spontaneously. This could occur if such a lesion became exposed to the oral cavity and decompressed. There was no subjective or objective evidence that the cyst had been infected or that spontaneous drainage had ever occurred.