Delayed eruption of premolars with periodontitis of primary predecessors and a cystic lesion: a case report

Multiple Radicular Cysts in an 8-year-old: A Case Report

Aim

The aim of this article is to report a case of multiple radicular cysts in an 8-year-old.

Background

Multiple radicular cysts are an uncommon and rare entity in mixed dentition. Management of these cysts needs careful examination of the present deciduous and erupting permanent dentition. Here, we present a case of multiple radicular cysts in an 8-year-old with no other significant medical history. The treatment approach included removal of the involved deciduous teeth and enucleation of cysts, followed by curettage and the use of Whitehead's varnish.

Case description

The patient reported to the department with a chief complaint of pain in the right lower front tooth region and upper left back tooth region for 2 months. There was no relevant medical or dental history. A routine panoramic radiograph was done, which revealed multiple radiolucency. Clinical presentation, radiograph, and aspiration cytology concluded the diagnosis as multiple radicular cysts. The treatment plan for management was the extraction of the teeth involved, followed by enucleation. Whitehead's varnish dressing was placed in the extraction socket. A regular follow-up was done, showing the absence of radiolucency and eruption of permanent teeth.

Conclusion

Management of radicular cysts in mixed dentition is challenging. Preserving the vitality of erupting permanent teeth is of utmost importance.

Significance

Multiple radicular cysts are an uncommon finding in young children. Proper medical history is important to rule out any syndrome. Correct diagnosis and early management are prognostic factors.

How to cite this article

Sharma A, Chhabra A, Sharma I, et al. Multiple Radicular Cysts in an 8-year-old: A Case Report. Int J Clin Pediatr Dent 2023;16(S-3):S317-S320.

Inflammatory follicular cysts associated to necrotic primary teeth

BACKGROUND

Cysts are pathological cavities lined by epithelium and supported by connective tissue, containing fluid or semi-fluid substances and presenting developmental or inflammatory origins.

CASE REPORT

This study aimed to evaluate a case series of inflammatory follicular cysts in children to clarify their nomenclature, diagnosis, clinical implications and treatment outcomes. Prevalence, aetio-pathogenesis, clinical, radiographic and microscopic findings, treatments and sequelae of this condition were assessed by using the records of patients treated between 2000 and 2015. Data were analysed and presented descriptively.

FOLLOW-UP

This was performed periodically for 2 years to monitor lesion regression and complete eruption of impacted permanent teeth. All of the involved permanent teeth erupted naturally. Twelve cases of asymptomatic lesions with volumetric bone expansion were identified through radiographic findings or delayed tooth eruption in patients aged between 8 and 14 years. After establishing the diagnosis of inflammatory follicular cyst, necrotic primary teeth extraction was followed by decompression of the cystic lesions.

CONCLUSIONS

The investigated cases were consistent with inflammatory follicular cyst diagnoses. The proposed treatment was considered to be appropriate, that was revealed by the maintenance of the permanent teeth involved during the patients follow-up.

Role of inflammation in developmental odontogenic pathosis

Periapical infection in the primary tooth may lead to periapical abscess, granuloma, radicular cyst and even osteomyelitis. The infection in primary teeth can also affect the developing successor teeth leading to hypomineralization, hypoplasia, arrest of tooth development, regional odontodysplasia, delayed eruption etc. The purpose of this article is to report a case of malformed permanent tooth in relation to overlying infected deciduous teeth. The probable role of inflammation in pathogenesis of the present condition is also being discussed.

Spontaneous alignment of permanent successors after enucleation of odontogenic cysts associated with primary teeth

Pulpotomy and pulpectomy occasionally lead to cyst formation in the primary dentition. They show specific clinical features of large size, rapid growth, buccal expansion and displacement of permanent teeth. Complete enucleation of the cyst with extraction of the associated primary teeth and preservation of the permanent teeth appeared to be the most suitable treatment option. Normal alignment of the permanent teeth occurred spontaneously even their initial positions were highly unfavourable.

Morphological and clinical considerations of first and second permanent molar eruption disorders

Tooth eruption is a complex biological process which starts from the site of development in the jaw bone until the teeth reach their final functional position in the chewing plane. Various factors can disturb this process. Besides mechanical obstacles on the eruption path, a pathological position or axial orientation of the tooth germ, morphological aberrations of the tooth or pathological alterations of the periodontium, primary disorders of the eruption mechanism may lead to complete or partial retention of the tooth in the jaw bone. These morphological features bear upon the prognosis of orthodontic correction which is dependent upon the underlying cause. First and second molars are rarely affected by eruption disorders, with a prevalence of 0.01 to 0.08 per cent, however, marked consequences for function such as posterior open bite or elongation of the antagonists may result. Following an overview of pathogenetic factors of tooth eruption disorders, selected cases of impacted first and second permanent molars are presented with respect to their morphological causes.

Delayed tooth eruption: pathogenesis, diagnosis, and treatment. A literature review

Delayed tooth eruption (DTE) is the emergence of a tooth into the oral cavity at a time that deviates significantly from norms established for different races, ethnicities, and sexes. This article reviews the local and systemic conditions under which DTE has been reported to occur. The terminology related to disturbances in tooth eruption is also reviewed and clarified. A diagnostic algorithm is proposed to aid the clinician in the diagnosis and treatment planning of DTE. The sequential and timely eruption of teeth is critical to the timing of treatment and the selection of an orthodontic treatment modality. This review addresses the need for a more in-depth understanding of the underlying pathophysiology of DTE and gives the clinician a methodology to approach its diagnosis and treatment.