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James H. - #549-4-82

James H. - #549-4-82. Dentigerous cyst Kelly McCracken Team 1. Patient Medical History. 43 year old White male Had experienced trauma on the contralateral side of the head (area of #19) Asthmatic with mold allergies Previous tobacco user for 20 years, successful cessation six years ago

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James H. - #549-4-82

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  1. James H. - #549-4-82 Dentigerous cyst Kelly McCracken Team 1

  2. Patient Medical History 43 year old White male Had experienced trauma on the contralateral side of the head (area of #19) Asthmatic with mold allergies Previous tobacco user for 20 years, successful cessation six years ago Low caries risk Periodontal Case Type II

  3. Medications Ambien – PRN Percocet – PRN

  4. Lesion Description Radiographically, the lesion is a large, multi-locular, radiolucent lesion located in the ramus of the right mandible. It encompassed the entire third molar and the roots of the second molar. Clinically, presentation was within normal limits.

  5. Panoramic Radiograph (9/17/10)

  6. Patient Dialogue • Q: When was your last panoramic radiograph? A: About ten years ago • Q: Did the doctor mention anything unusual at that time? A: No • Q: Have you noticed any gradual swelling? A: No • Q: Does the right side of your jaw feel differently than the left side of your jaw? A: No, the left side has teeth that hurt. • Q: Was there a reason why your third molars were not taken out prophylactically? A: No.

  7. Diagnosis • Differential Diagnosis • Dentigerous Cyst • Periapical Cyst • Ameloblastoma • OKC • Provisional Diagnosis • Dentigerous Cyst • This is the second most common odontogenic cyst, which develops from the normal dental follicle that surround the unerupted tooth, like this patient’s impacted third molar. The most commonly effected teeth are the mandibular third molars and the maxillary canine. • Recommended Treatment • Remove the cyst. There is a low recurrence with a dentigerous cyst.

  8. Pathology Consult Please biopsy the large, multi-locular lesion located on the right ramus of the mandible. Because of the impacted third molar and location of the lesion, we believe it to be a dentigerous cyst. Thank you!

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