Case Report: Dentigerous Cyst in a Young Child

Introduction: Dentigerous cyst is the most common odontogenic and developmental cysts arising in the jaws.

Case report: A case of 5 year old Malay boy with Global Developmental Delay and epilepsy, presented with Severe Early Childhood Caries associated with badly carious left second primary molar (75) and acute left submandibular swelling. The radiology investigation was failed as he unable to cooperate. Comprehensive Dental Treatment under general anaesthesia was carried out. Intraoperatively, it was noticed that 75 was extracted with soft tissue lesion attached to its root together with an incomplete crown of unerupted premolar. The specimen was sent for histopathology investigation and identified as Dentigerous cyst. Post operatively he was reviewed after 6 months and the healing was uneventful. However, he was scheduled for long term review.

Discussion: Dentigerous cyst can arise early in life as a result of inflammation from preceding non-vital deciduous tooth however it is rare to have the cystic lesion underneath the primary root. However, in view of surgical findings and histopathology, this follicular cyst possibly originated from the fluid accumulation between the reduced enamel epithelium and the enamel surface of a newly formed tooth. Furthermore, the inflammatory lesion from the root of a non-vital deciduous tooth was the source of the development of dentigerous cyst around the unerupted permanent tooth bud.

Conclusion: It is infrequent to have a dentigerous cyst in a very young child. Nonetheless, appropriate medical assessment and treatment plan is essential. In this case, the cyst could be expand if it was not enucleated earlier.