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Referral details

Case 31945

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Referral category

Impacted / delayed / malpositioned / extra teeth

Region of interest

Right maxilla--displaced 13; rule out pathology (such as fibrous dysplasia)

Referral reason

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Canaray 31945

1. Superior displacement of tooth 13 by dentigerous cyst

The developing tooth 13 has been displaced superiorly by a dentigerous cyst that surrounds its crown. The root of tooth 13 is approximately 50% formed, and exhibits an open apex. The dentigerous cyst around the crown of tooth 13 is associated with the cementoenamel junction of the tooth, which is supportive of the diagnosis. This cyst has a uniformly radiopaque internal structure and a round overall shape. Mild displacement of the adjacent teeth 14 and 15 has occurred, but no root resorption is present on any of the teeth in the first quadrant.

Axial views of anterior first quadrant

These axial cross-sectional images demonstrate the buccal displacement of the maxillary alveolar process by the dentigerous cyst associated with tooth 13. The inferior aspect of the cyst scallops around the roots of tooth 14. Incidentally, tooth 12 exhibits dens invaginatus.

2. Dens invaginatus on tooth 12

Tooth 12 exhibits a prominent region of dens invaginatus which appears to be communicating with the oral cavity. This tooth likely has been devitalized and could serve as a potential source of secondary infection for the dentigerous cyst.

Coronal views of tooth 12

These coronal cross-sectional images demonstrate the continuous channel that extends from the intraoral region to the peripical region of tooth 12.

Normal tooth 14

Tooth 14 has not yet been affected by the adjacent dentigerous cyst. The roots of the tooth appear to be developing normally. However, the cyst has extended around the roots of the tooth, which may result in slightly malformed root apices of tooth 14.

Sagittal views of first quadrant

These sagittal cross-sectional images demonstrate the superior displacement of tooth 13 by the dentigerous cyst. The posterior border of the tooth is positioned against the floor of the right maxillary sinus. The cyst extends around the roots of the maxillary premolars and is continuous with the wide apical foramen of tooth 12.

3. Dens invaginatus on tooth 22

Tooth 22 exhibits dens invaginatus which has not yet been infected.