Title : Surgical removal of unerupted teeth associated with dentigerous cyst in the mandibular symphysis region - case report
Abstract:
Unerupted or impacted tooth is a dental organ that, even when fully developed did not erupt at the regular time, lying inside the bone completely surrounded by bone or bone and mucosal tissue. This paper aims to report a clinical case of a 14-year-old female patient who attended the Ambulatory of Maxillofacial Surgery and Traumatology Service at the Federal University of Pernambuco, reporting mentonian discomfort. The symptomatology was induced by an unerupted lower canines associated with two other supernumerary teeth that, radiographically had similar characteristics to canines surrounded by a radiolucent image suggesting a dentigerous cyst in the mentonian region of the mandible, in an atypical position of “Kisses Teeth”. Due to the extension of the lesion, the patient underwent a surgical procedure under general anesthesia in order to remove the teeth and the lesion. Firstly, incisions were performed, followed by osteotomies and ostectomies to approach the lesion. The elements were removed aided by Seldin elevators, then, cystic enucleation with cavity cleaning and bone regularization and the lesion was sent to perform the histopathological screening. Over the postoperative period, the patient evolved without philogistic signs and after 1 year, another facial radiography was requested for post-surgical control. Radiographically, the bone tissue healing in the region was observed, preserving the root apices of the inferior elements. Clinically, the patient presented with preserved tissues and all dental elements demonstrated pulp vitality. The radiographic aspect presented in our case report differs from the most common aspect mentioned in the literature, since the lesion comprised four dental elements involved by a single dentigerous cyst, reaching larger proportions. The case reported here is considered rare because the impacted teeth was in the mandibular region and the prevalence of unerupted canine occurs more frequently in upper canines. They also presented with their normal size, with no association of traumas in the region and without loss of early deciduous elements. In addition, the dentigerous cyst was crossing the median line which characterizes another variant, once it involves multiple dental elements. The unerupted canines study is very important in Dentistry, since successful results depend on correct and early diagnosis for proper management and success of the proposed treatment.
