Tooth-bearing cysts, also known as follicular cysts, occur after the crown or root of the tooth is formed, and liquid oozes out between the residual enamel epithelium and the crown surface of the tooth. It can be from one tooth germ (including one tooth) or from multiple tooth germs (including multiple teeth). Dental cysts are often associated with impacted mandibular third molars. Most of them are asymptomatic at first, and continuous growth can cause jaw bulge and facial deformities. Some cases are accidentally discovered during X-ray examination. As cysts expand, they can cause teeth to loosen, shift, or fall out.
When the low-impacted teeth in a tooth-bearing cyst are closely related to the inferior alveolar nerve, the curettage of the cyst or the extraction of the impacted tooth will cause damage to the inferior alveolar nerve. In the treatment of tooth-bearing cysts, a crown cut that removes the crown and retains the root of the tooth is helpful to reduce nerve damage or pathological fracture of the mandible.
The peak age of onset of dental cysts is between 10 and 39 years old; in childhood, the incidence of dental cysts is slightly higher than that of other jaw cysts. There are more male patients than female patients. The location of the disease is related to age: patients under 10 years old are mostly located in the mandibular premolars, patients aged 10-20 years old are mostly located in the upper permanent canines, mandibular third molars and mandibular second premolars, and in patients over 20 years old, the lesions are mostly located in the third mandibular premolars. molar.
In the cyst area, the affected tooth did not erupt. The cyst grows slowly and is an expansive growth, similar to the primordial cyst. The puncture can get grass yellow sac fluid, and cholesterol crystals can be seen under the microscope.
X-rays show circular or elliptical transmission areas, with clear and neat edges, and the cyst cavity contains crowns. Most of them are unilocular, and a few are multilocular.
The principle of treatment is cyst curettage. Both the upper and lower jaw cysts can be operated in the mouth. In addition to removing the cyst wall, the operation also needs to extract the affected tooth contained in the cyst. However, for children with tooth-bearing cysts during eruption, when it is estimated that the affected tooth may erupt to the normal position, the cyst cavity can be opened, the upper cyst wall can be removed, and the affected tooth can be preserved and allowed to erupt naturally. The interdental space on it should be maintained with a retainer to facilitate It erupts normally.
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