CHAPTER 1

INTRODUCTION

1.1 Background

Dentigerous cysts are the most common benign odontogenic cysts

of developmental type that are usually single in occurrence (Naclério et al,

2003). The dentigerous cyst initially is always associated with the crown

of an impacted, embedded, or unerupted tooth.  It develops around the

crown of the unerupted tooth by the expansion of the follicle when fluid

collects or space occurs between the reduced enamel epithelium and the

enamel of an impacted tooth. Dentigerous cysts occur predominantly in

the third molar region of the mandible, followed in frequency by maxillary

canine, maxillary third molar, and rarely in relation to maxillary central

incisor (Pramod, 2011). Dentigerous cyst develops by accumulation of

fluid between reduced enamel epithelium and enamel or within the enamel

organ. Pressure exerted by an erupted tooth on an impacted follicle

obstructs the venous outflow. This leads to rapid transudation of serum

across the capillary walls. Increase in the hidrostatitc pressure of the

pooling fluid occurs, leading to separation of follicle from the crown with

or without reduced enamel epithelium. An intrafollicular spread of

periapical inflammation from a deciduous tooth may also result in the

development of dentigerous cyst (Devi et al, 2010). The dentigerous cyst

is a congenital anomaly which appears at early stages of organogenesis.

The cystic structure is generally developed together with heterotopic

polydontia (Wapf & Nuss, 2005; Brown et al., 2007).

1.2 Issue

A 45 year old female patient came to the dental clinic complaining of

swelling in the left upper jaw that has been going on for 2 years. The

swelling slowly enlarges and lately the teeth in that region was prominent

and dislocating. In addition, she also gets pain. She has been given

antibiotics and anti-inflammatory but it didn’t work and the swelling has

never become smaller.

1.3 Problem statements

1.3.1 How is the histopathology, pathology, imunopathology and

pathobiology of non-infectious oral disease ?

1.3.2 How is the clinical features of dentigerous cyst ?

1.3.3 How is the rontenology of dentigerous cyst ?

1.3.4 How does the histopathology of dentigerous cyst ?

1.3.5 How does the pathogenesis of dentigerous cyst ?

1.4 Benefits

1.4.1 Students can explain about histopathology, pathology,

imunopathology and pathobiology of non-infectious oral disease

1.4.2 Students better understand about the clinical features of

dentigerous cyst

1.4.3 Students learn the rontenology of dentigerous cyst

1.4.4 Students know the histopathology of dentigerous cyst

1.4.5 Students better understand about the pathogenesis of dentigerous

cyst

1.5 Purpose

After completing this module, the fourth grade student at dentistry of

Airlangga University are able to explain the histopathology, pathology,

pathology, imunopatologi, clinical features, rontgenologi, disorders and

the epidemiology of non-infectious oral disease.

PREFERENCES:

Naclério Homem MG, Simões WA, Zindel Deboni MC, Chilvarquer I, Traina

AA (2003). Dentigerous cyst associated with an upper permanent central

incisor: case report and literature review. Journal of Clinical

Pediatric Dentistry;27(2):187-92.

Wapf, P. & K. Nuss, (2005) Dentigerous cyst in a calf. The Veterinary Record,

156, 580–582.

Pramod, D.S.R & Jeevendra, Nath Shukla (2011) Dentigerous Cyst of Maxilla in

a Young Child. Natl J Maxillofac Surg. 2(2): 196

Brown, C. C., D. C. Baker & I. K. Barker (2007) The alimentary system. In: Jubb,

Keneddy & Palmer’s Pathology of Domestic Animals, vol 2., 5th edn, ed

Maxie, M.G., W. C. Saunders Ltd, USA, p.7.

Devi, Parvathi; Bhovi, Thimmarasa V.; Mehrothra, Vishal; Agarwal, Mayuri

(2010) Multiple Dentigerous Cyst. Cyst and Tumor. J.maxillofacial Oral

surgery 13(1): 63