• The Journal of the Korean dental association
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• v.47 no.10
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• pp.628-636
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• 2009

낭은 상피세포로 싸여있는 병적인 공간으로 내부가 액체나 반액체로 채워져 있다. 악골에서 낭은 다른 골 부위에서보다 더 흔하게 발생하는데 이는 대부분의 낭이 치아 형성 후에 악골에 남아있는 치성잔류물로부터 발생하는 경우가 많기 때문이다. 구강악안면부에서 발생하는 낭은 연조직에서 발생할 수도 있지만 대부분 골내에서 발생하고, 법랑질 상피나 치배와 관련해 악골내에 발생하는 치낭성이다. 치낭성은 WHO분류에서 발생근원에 따라 크게 염증성과 발육성 기원의 두 가지 군으로 분류되고, 발육성 낭은 치성과 비치성으로 세분할 수 있다. 악골에 발생하는 낭은 대부분이 치낭성이며 가장 흔한 악골 낭종은 치근단낭으로 염증성이고, 발육성인 함치성낭과 치성각화낭도 다음으로 발생률이 높은 편이다. 소아환자에서 함치성낭과 치성각화낭의 발병률이 성인보다 더 높았다. 비치성낭 중에서 비구개관낭이 가장 많이 발생하며, 연조직에서 발생하는 낭과 상피세포 경계가 없는 낭성 병소인 가성낭(pseudocyst)은 드물게 관찰된다. WHO에서 치성각화낭과 서회화치성낭은 파괴적 성장을 하고 재발 경향이 높으므로 양성 낭성 종양으로 재분류하고 있다.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.4
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• pp.718-724
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• 2008

Tooth impaction is a frequently observed eruption anomaly in pediatric dental practice. Young patients with impacted or unerupted teeth have more prediction for dentigerous cyst formation. Dentigerous cyst presents radiographic features, unilocular or multilocular radioluscency. Cysts occur most frequently in the premolar region except third molar. Dentigerous cysts can grow to a considerable size, and large cysts may be associated with a painless expansion of the bone in the involved area. Extensive lesions may result in facial asymmetry, osseous destruction, root resorption of proximal teeth and displacement of associated tooth. The nature of the causative tooth influences the type of surgical treatment required for the dentigerous cyst. If the cyst is associated with a supernumerary or wisdom tooth, complete enucleation of the cyst along with extraction of tooth may be the first treatment choice. Otherwise, preservation of the associated teeth should be considered to prevent a young patient from psychological and mental trauma because of the loss of tooth. We should consider the degree of tooth displacement, osseous destruction and growth pattern of oromaxillofacial area when planning treatment. Thus a proper and logical treatment planning can help a proper growth and development of oromaxillofacial area and can save the patient from a psychological and mental trauma. This report describes 4 cases of the management of impacted premolars and molars associated with dentigerous cysts in children.

• Journal of the korean academy of Pediatric Dentistry
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• v.41 no.1
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• pp.85-92
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• 2014

Dentigerous cyst is the most common developmental odontogenic cyst of the jaw which is associated with unerupted teeth. Treatment modalities range from enucleation to marsupialization. Enucleation is the process in which the cyst is completely removed, and this is usually indicated for smaller lesions. Larger cysts can be treated by marsupialization, which is a process that consists of making a surgical cavity on the wall of the cyst, emptying its content and maintaining the continuity between the cyst and the oral cavity. This procedure allows decompression of the cyst, regeneration of the bone-defected area, and also lets the wall of the cyst change into normal mucosa. This technique will protect adjacent structures and will promote spontaneous eruption of succedaneous teeth previously surrounded by the cyst. These are two case reports of a 5-year-old and an 11-year-old boy with dentigerous cysts found regarding supernumerary tooth and pulpotomized mandibular primary molars, respectively. Due to the large size of the cysts, both cases were treated with marsupialization. This case report shows that in cases regarding large-sized dentigerous cysts, marsupialization can be an effective surgical technique that promotes spontaneous eruption of cyst-involved succedaneous teeth and the preservation of adjacent teeth.

• Journal of the korean academy of Pediatric Dentistry
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• v.42 no.1
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• pp.22-29
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• 2015

The purpose of this study was to evaluate the eruption patterns of mandibular premolars associated with dentigerous cysts after marsupialization regarding the depth, angulation and root development of impacted teeth. Spontaneous eruption was found in 93% of mandibular premolars after marsupialization. Eruption speed and rate of angulation change were greater in mandibular premolars associated with a cyst than those on the non-cyst side. The group with less matured roots tended to have greater eruption speed and angulation change. The eruption speed and angulation change declined rapidly during the first 6 months after marsupialization. Based on the results of this study, it might be possible to predict the eruption pattern of mandibular premolars associated with a cyst after marsupialization, which would be useful for treatment planning.

• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.1
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• pp.1-7
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• 2001

The Dentigerous cyst is reported to be one of the most common lesions of the jaw. It is derived from reduced enamel epithelium that surrounds the crown of an unerupted tooth. Dentigerous cysts usually remains asymptomatic and presents as well-circumscribed radiolucencies surrounding the crown of a tooth. Most dentigerous cysts are treated by surgical enucleation or marsupialization of the cyst to allow eruption of the permanent tooth. The nasopalatine duct cysts derived from the islands of epithelium remaining after closure of the embryonic nasopalatine duct. The cyst presents as a well-circumscribed oval or heart-shaped radiolucency located in the midline of the anterior maxilla between the roots of the central incisors. Treatment is by surgical enucleation, employing a palatal approach. This report present two cases. One case was diagnosed with dentigerous cyst and treated by enucleation. 12 Months later, affected second premolar was erupted normally. The other case was diagnosed with nasopalation duct cyst. Histological examination of the enucleated cyst confirmed a nasopalatine duct cyst. There was no recurrence during follow up period.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.2
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• pp.169-179
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• 2004

The purpose of this study was to discriminate clinically and radiographically among the three groups of dentigerous cysts studied. First, Group I, involved area of dentigerous cyst was successive permanent tooth area beneath deciduous tooth. Second, Group II, involved permanent molar area, and the last, Group III involved maxillary anterior supernumerary tooth area. The author observed and compared the clinico-radiographic features of 49 cases of Group I, 36 cases of Group II, and 15 cases of Group III of dentigerous cyst and this observation and comparison had been done by based on the charts and panoramic films. The obtained results were as follows: 1. The cases of Group I were 29 cases and, those of Group II were 36 and those of Group III were 15. 2. The incidence of dentigerous cyst is high in first decade. In Group I, before first decade and early first decade was 87.8%, in Group II and Group III, was discovered more lately. 3. The frequency of dentigerous cyst is 2.5 times higher in male than in female. 4. The sequence of chief complaint was swelling(50%), routine examination(32%), and pain(9%). 5. When considering the type of the cyst, lateral type is many most in Group I (71.4%) and central type is many most in Group II (94.4%) and Group III (100%). 6. The most size of dentigerous cyst was 2 crown size in Group I, 1 crown size in Group II, above of 4 crown size in Group III. 7. Almost involved teeth showed displacement and some tooth of displaced teeth showed delayed root development and dilaceration of root. 8. The most many response of alveolar bone was buccal bone expansion in Group I (67.3%), no bone expansion in Group II(66.7%) and palatal bone expansion in Group III (60.0%). 9. The percentage of involved teeth were as follows : The mandibular third molar was 31% and many most. The mandibular second premolar was 30%. Mesiodens of maxillary anterior area was 15%. The maxillary canine was 8%. The mandibular first premolar was 5%. 10. In the Group I, causes suggesting of dentigeous cyst are pulpotomized deciduous tooth(59.2%), severe dental caries of deciduous tooth, untreated traumatic history on the deciduous tooth etc. 11. The treatment method of dentigerous was marsupialization in 61.2% of cases of Group I and that was enucleation in 61.1% of cases of Group II and in 80.0% of cases of Group III.

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.3
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• pp.473-480
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• 2007

The dentigerous cyst originates through alteration of stellate reticulum after amelogenesis has completed, with accumulation of fluid between the layers of the reduced enamel epithelium or between this epithelium and the tooth crown. Its incidence is relatively high on 10s or 20s of age and it is always related to the unerupted crown. Generally, it has no symptom, however, if the cyst is large or accompanied with pus formation, swelling and pain may occur. In radiographic findings, it shows impacted crown surrounded by well defined unilocular radiolucent lesion and occasionally displacement of adjacent teeth or root resorption. The goal of treatment is complete elimination of abnormal tissue preserving the tooth involved in the cyst. Enucleation and marsupialization are commonly used for the treatment. Marsupialization is the procedure which removes the partial portion of the cystic wall and connects with the oral mucosa. As the pressure in the cyst decreases, bone regeneration takes place in the defect area and cystic wall converts into normal mucosa. This procedure, however, is the most conservative procedure which allows the protection of adjacent important structures. If the eruption space is sufficient, then inducing the eruption of the permanent tooth in the cyst is also possible. In following cases, dentigerous cyst was diaganosed after clinical and radiographic examination. Marsupialazation was done to remove the cyst and induce the tooth, which was in the cyst, to erupt into the oral cavity.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.2
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• pp.270-274
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• 2009

Dentigerous cysts generally encompass the crown of an unerupted tooth. These cysts are usually solitary. They are the second most common odontogenic type of cysts following radicular cysts, and are frequently associated with impacted mandibular third molars or maxillary canines. Most multiple cysts found in the jaw are odontogenic keratocysts associated with the nevoid basal cell carcinoma syndrome, mucopolysaccharidoses and cleidocranial dysplasia. Although a single dentigerous cyst is well documented in the medical literature, including the prevalence, treatment and prognosis, multiple dentigerous cysts without any systemic symptoms is unusual. Furthermore, cases involving both the maxilla and mandible are especially rare. We present the case of an 11-year-old boy with nonsyndromic multiple dentigerous cysts associated with a mandibular second premolar and a maxillary canine. The treatment was conservative and included marsupialization and eruption guidance. Further follow up is planned to rule out additional problems and the possible identification of a syndrome.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.4
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• pp.731-736
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• 2008

Odontogenic keratocyst is classified as a developmental odontogenic cyst and is believed to arise from cell rests of the dental lamina. It accounts for 3% to 11% of all jaw cysts and they occur twice as often in the mandible as in the maxilla. Histologically, the cysts are lined by stratified, keratinizing, squamous epithelium. Daugther cysts or microcysts are often observed microscopically. The recurrence rate has been reported variously, but is known by its high recurrence rate. These lesions are more common in males than in females, occur over a wide age range and are typically diagnosed during the 2nd and 3rd decade. The diagnosis depends on the cyst’s microscopic features and is independent of its location and radiographic appearances. This cyst is a radiolucent lesion that is often multiloculated, has a smooth or scalloped border. The cyst is characteristically located in the body and ramus of the mandible, and often occurs in conjunction with an impacted tooth. This case report describes an odontogenic keratocyst on the lower right molar area of an 8-year-old girl. The cyst was removed under the general anaesthesia, and is being checked regularly for any recurrences.

• Journal of the korean academy of Pediatric Dentistry
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• v.43 no.3
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• pp.237-245
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• 2016

This study aimed to identify the characteristics of jaw cysts among children and adolescents treated at the Kyung Hee University Dental Hospital from 2005 to 2015. A retrospective observational study was conducted of 269 jaw cysts diagnosed in 253 patients. The following variables were recorded: gender, age, prevalence and location of lesions, clinical symptoms and treatment. Statistical analyses were performed using the SPSS (version 20.0). Our results suggest that the cysts are slightly more prevalent in males. Cystic lesions of the jaws in children are predominantly odontogenic and developmental in origin. Dentigerous cysts predominate in developmental cysts and the most frequent diagnosis is radicular cysts in inflammation cysts. The most common location of the cysts is in the mandible, particularly the lower molar region. In numerous cases, the patients have no clinical symptoms. Most cysts were surgically enucleated with tooth extraction. Furthermore, our findings demonstrate that the characteristics of jaw cysts in children are distinctive and differ in several respects from the corresponding distribution of jaw cysts in adult population. Therefore, knowledge of the clinical, radiological and histopathological behavior of jaw cysts and periodic radiographic examination are key factors for early diagnosis and adequate treatment of jaw cysts in children.