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Dentigerous cysts develop within the normal dental follicle that surrounds an unerupted or partially erupted permanent tooth. They are usually seen in relation to mandibular third molars, but can occur in any other location in the jaws. These cysts are usually asymptomatic and can be an incidental finding in a radiograph. However, sometimes they can grow very large and appear as a bony swelling. Radiographically, they appear as well-demarcated radiolucent lesions attached at an acute angle to the cervical area of an unerupted tooth. The border of the lesion may be sclerotic. Sometimes these cysts can grow large enough to cause pathological fracture. Occasionally mucoepidermoid carcinoma, ameloblastoma and squamous cell carcinoma can arise from the walls of a dentigerous cyst; hence removal of the cyst is recommended. If the cyst is small, a radiological monitoring is recommended.


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Figure 1: Dentigerous cyst: Panoramic radiograph showing a well-defined radiolucency with sclerotic border encompassing the crown of last molar on the left side of the lower jaw and extending from the mid part of ramus to the periapical region of the first molar. The second molar is missing. The lower border of mandible is expanded. The right mandiblar last molar is also horizontally impacted.
Figures 2: Dentigerous cyst. Coronal and axial CT scans showing a circumscribed cystic lesion encompassing an impacted tooth in the left maxillary anterior region.
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