Journal of Maxillofacial and Oral Surgery

, Volume 11, Issue 4, pp 458–465 | Cite as

A Study on Dentigerous Cystic Changes with Radiographically Normal Impacted Mandibular Third Molars

  • Greeshma G. Wali
  • V. SridharEmail author
  • H. N. Shyla
Original Paper



Dentigerous cyst develops in the follicular tissue surrounding the impacted lower third molar. A study was carried out to know the incidence of Association of Dentigerous cyst with radiographically normal impacted lower third molars and to draw the attention of the Oral Surgeons towards the prophylactic removal of impacted third molars.


A prospective study was done on 30 patients with impacted lower third molars which were indicated for extraction. The follicle tissue surrounding the impacted tooth was subjected for histopathologic investigations. Only those teeth with a radiographic finding of pericoronal space of less than 2.5 mm were considered. Two Oral Pathologists reviewed the slides for any changes suggestive of cystic pathology.


Pathologic changes suggestive of Dentigerous cyst was found in 7 of the 30 follicular tissue sent for histopathologic testing. It was found to be statistically significant (P < 0.001).


This study shows statistically high incidence of Dentigerous cyst association with radiographically normal impacted lower third molar teeth. Hence the Oral and Maxillofacial surgeons should consider histopathologic evaluation and radiographic diagnosis in the management of impacted lower third molars. Prophylactic extractions of normal impacted lower third molars should be considered as a treatment option.


Impacted lower third molars Prophylactic extraction Dentigerous cyst 


  1. 1.
    Alling C, Helfrich JF, Alling RD (1993) Impacted teeth, 1st edn. Saunders, PhiladelphiaGoogle Scholar
  2. 2.
    Bhaskar SN (1991) Orban’s oral histology and embryology, 11th edn. Mosby, St. LouisGoogle Scholar
  3. 3.
    de Oliveria DM, de Souza Andrade ES, Marcia M, da Silveria F, Camargo IB (2008) Correlation of the radiographic and morphological features of the dental follicle of third molars with incomplete root formation. Int J Med Sci 5:36–40CrossRefGoogle Scholar
  4. 4.
    Gorlin RJ (1957) Potentialities of oral epithelium manifested by mandibular dentigerous cyst. Oral Surg Oral Med Oral Pathol 10:271PubMedCrossRefGoogle Scholar
  5. 5.
    Daley TD, Pringle GA (1994) Relative incidence of odontogenic tumors and oral and jaw cysts in a Canadian population. Oral Sur Oral Med Oral Pathol 77:276–280CrossRefGoogle Scholar
  6. 6.
    Kramer I, Pindborg J, Shear M (1992) Epithelial cysts. In: Kramer I, Pindborg J, Shear M (eds) Histological typing of odontogenic tumours, 2nd edn. Springer-Veralag, World Health Organization, Geneva, pp 36–40Google Scholar
  7. 7.
    Muller SS, Bear LR (1994) Pericoronal radiolucencies with and without radio opacities. Dent Clin North Am 38:51–61Google Scholar
  8. 8.
    Farah CS, Savage NW (2002) Pericoronal radiolucencies and the significance of early detection. Aust Dent J 47(3):262–266PubMedCrossRefGoogle Scholar
  9. 9.
    Knight EM, Brokaw WC, Kesster HI (1991) The incidence of dentigerous cysts associated with a random sampling of unerupted third molars. Gen Dent 39:96Google Scholar
  10. 10.
    Adelsperger J, Campbell JH, Coates DB, Summerlin D-J, Tomich CE (2000) Early soft tissue pathosis associated with impacted third molars without pericoronal radiolucency. Oral Surg Oral Med Oral Pathol Endod 89:402–406CrossRefGoogle Scholar
  11. 11.
    van der Linden W, Cleaton-Jones P, Lownie M (1995) Disease and lesions associated with third molars. Review of 1001 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 79:142–145PubMedCrossRefGoogle Scholar
  12. 12.
    Berge TI (1997) Inability to work after surgical removal of mandibular third molars. Acta Odontol Scand 55(1):64–69PubMedCrossRefGoogle Scholar
  13. 13.
    Damante JH, Fleury RN (2001) A contribution to the diagnosis of the small dentigerous cyst or the paradental cyst. Pesqui Odontol Bras 15(3):238–246PubMedCrossRefGoogle Scholar
  14. 14.
    Peterson LJ (1992) Principles of oral and maxillofacial surgery, vol 1. JB Lip-pincott, PhiladelphiaGoogle Scholar
  15. 15.
    Ledyard BC (1953) A study of the mandibular third molar area. Am J Orthod 39:130–139CrossRefGoogle Scholar
  16. 16.
    Björk A, Jensen E, Palling M (1956) Mandibular growth and third molar impaction. Acta Odont Scand 14:231–272CrossRefGoogle Scholar
  17. 17.
    Kim J, Ellis GL (1993) Dental follicular tissue: misinterpretation as odontogenic tumours. J Oral Maxillofac Surg 51:762–767PubMedCrossRefGoogle Scholar
  18. 18.
    Stanley HR, Krogh H, Pannkuk E (1965) Age changes in the epithelial components of the follicles associated with impacted third molars. Oral Surg Oral Med Oral Pathol 19:128–139PubMedCrossRefGoogle Scholar
  19. 19.
    Consolaro A (1987) Caracterização microscópica de folículos pericoronários de dentes não-irrompidos e parcialmente irrompidos; Sua relação com a idade. Doctoral Thesis, Faculdade de Odontologia de Bauru Universidade de São Paulo, BauruGoogle Scholar
  20. 20.
    Glosser JW, Campbell JH (1999) Pathologic change in soft tissue associated with radiographically ‘normal’ third molar impactions. Br J Oral Maxillofac Surg 37:259–260PubMedCrossRefGoogle Scholar
  21. 21.
    Curran AE, Damm DD, Drummond JF (2002) Pathologically significant pericoronal lesions in adults: histopathologic evaluation. J Oral Maxillofac Surg 60:613–617PubMedCrossRefGoogle Scholar
  22. 22.
    Kalaskar RR, Tiku A, Damle SGJ (2007) Dentigerous cysts of anterior maxilla in a young child: a case report. Indian Soc Pedod Prev Dent 25:187–190CrossRefGoogle Scholar
  23. 23.
    Regezi JA, Sciubba JJ (1993) Cysts of the oral region. In: Oral pathology: clinical and pathological correlations, 2nd ed. WB Saunders, Philadelphia, pp 322–361Google Scholar
  24. 24.
    Baykul T, Saglam AA, Aydin U, Basak K, Isparta MD (2005) Incidence of cystic changes in radiographically normal impacted lower third molar follicles. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 99:542–545PubMedCrossRefGoogle Scholar
  25. 25.
    Daley TD, Wysocki GP (1995) The small dentigerous cyst. A diagnostic dilemma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 79:77–81PubMedCrossRefGoogle Scholar
  26. 26.
    Shear M (1983) Cysts of the Oral regions, 2nd edn. John Wright PSG, Bristol, pp 56–63Google Scholar
  27. 27.
    Bernick S (1949) Dentigerous cysts of the jaws. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2:914–921Google Scholar
  28. 28.
    Browne RM (1972) Metaplasia and degeneration in odontogenic cysts in man. J Oral Pthol Med 1:145–158CrossRefGoogle Scholar
  29. 29.
    Hattab FN, Rawashdeh MA, Fahmy MS (1995) Impaction status of third molars in Jordanian students. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 79:24PubMedCrossRefGoogle Scholar
  30. 30.
    Eliasson S, Heimdahl A (1989) Pathologic changes related to long term impaction of third molars: a radiographic study. Int J Oral Maxillofac Surg 18:210–212PubMedCrossRefGoogle Scholar
  31. 31.
    Dachii SF, Howell FV (1961) A survey of 3,874 routine full mouth radiographs. Oral Surg 14:1165CrossRefGoogle Scholar
  32. 32.
    Ahlqwist M, Grondahl H-G (1991) Prevalence of impacted teeth and associated pathology in middle-aged and older Swedish women. Community Dent Oral Epidemiol 19:116–119PubMedCrossRefGoogle Scholar
  33. 33.
    Rakprasitkul S (2001) Pathologic changes in the pericoronal tissues of unerupted third molars. Quintessence Int 23:633–638Google Scholar
  34. 34.
    Stanley HR, Krogh H, Pannkuk E (1965) Age changes in the epitelial components of follicles (dental sacs) associated with impacted third molars. Oral Surg 19:128–139PubMedCrossRefGoogle Scholar
  35. 35.
    Knutsson K, Brehmer B, Lysell L, Rohlin M (1996) Pathosis associated with mandibular third molars subjected to removal. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 82:10–17PubMedCrossRefGoogle Scholar

Copyright information

© Association of Oral and Maxillofacial Surgeons of India 2011

Authors and Affiliations

  1. 1.ITS Dental College and HospitalGhaziabadIndia
  2. 2.Rural Dental CollegeLoniIndia
  3. 3.KLE Institute of Dental SciencesBangaloreIndia

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