Bilateral Nonsyndromic Cystic Lesions Involving Impacted Teeth: Nomenclature and Diagnostic Protocol

To present a brief overview of etiopathogenesis, nomenclature, and treatment modality for a case of nonsyndromic bilateral cysts in the mandible.

Odontogenic cysts, though comprise a distinct group of lesions have on and off posed challenges in etiopathogenesis and nomenclature. The prima facia role of development/inflammation in the buildup of fluid between the reduced enamel epithelium attached at the cementoenamel junction and the enamel in the pathogenesis of dentigerous cysts has long been discussed. Along with this, the spread of inflammatory exudate from an overlying primary tooth could also be the source of an inflammatory dentigerous cyst.

Bilateral swellings in a 12-year-old patient presented with a chief complaint of pain in the lower jaw for 4 months. The radiographic picture exhibited unilocular, well-circumscribed radiolucent areas extending from 34 to 37 on the left side and from 44 to 47 on the right side of the mandible and involving retained mandibular second premolars on both sides.

Mere expansion of a follicle due to inflammation from an overlying infected/necrosed/treated primary tooth in which the reduced enamel epithelium does not appear to be attached at the cementoenamel junction should be aptly referred to as an "inflammatory follicular cyst".

The present article attempts to illuminate the notable differences between dentigerous cysts and inflammatory follicular cysts of jaws which requires an adequate distinction in pediatric cases for diagnostic and management considerations.

Sethi A, Shetty DC, Tandon A, et al. Bilateral Nonsyndromic Cystic Lesions Involving Impacted Teeth: Nomenclature and Diagnostic Protocol. Int J Clin Pediatr Dent 2020;13(4):429-432.