Dentigerous cysts with calcification mimicking odontogenic tumors: differential diagnosis by CT
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This study aimed at clarifying whether we can differentiate dentigerous cysts with calcified substances from other odontogenic tumors that include calcification and the crown of an unerupted tooth by CT findings.
We retrospectively selected histopathologically confirmed cases that included calcified substances and the crown of an unerupted tooth inside. There were 22 cases with eight pathological categories. Besides seven odontogenic tumors, we included dentigerous cysts, which were usually recognized without calcification within the lesions. We divided the cases into two groups: 14 cases of odontogenic tumors and 8 cases of dentigerous cysts. Cases were analyzed for various CT findings such as continuity with the alveolar crest, bone sclerosis around the lesion, and sizes and shapes of high CT value substances, as well as demographic factors. Comparisons between the groups for each analytical factor were performed.
Dentigerous cysts with dystrophic calcification showed unique CT findings such as bone sclerosis around the lesion, continuity with the alveolar crest, and small scattered calcified substances near the crown of an unerupted tooth, compared with typical dentigerous cysts and other odontogenic tumors. On the other hand, odontogenic tumors showed various patterns in the location and distribution of high CT value substances, and we could only differentiate odontoma using its very high CT values.
Although the patterns of calcification were not the main characteristic findings, it may be possible to differentiate dentigerous cysts with dystrophic calcification from odontogenic tumors by their other characteristic CT findings, and unnecessary extensive surgery can also be avoided.
KeywordsDentigerous cyst Odontogenic tumors Calcification Diagnosis CT
Conflict of interest
Mayumi Shimizu, Dai Ogawa, Kazutoshi Okamura, Toshiyuki Kawazu, Toru Chikui, and Kazunori Yoshiura declare that they have no conflict of interest.
Human rights statement and informed consent
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). As this was a retrospective study, written consent of the involved patients could not be obtained. Instead, the protocol of our study was provided on the website of our department. When the involved patients did not agree to have their data used, their data were excluded from the study. The Ethics Committee of our university hospital reviewed and approved the study protocol (No. 25-181).