Differential diagnosis Mural ameloblastoma



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There is a well-defined unilocular round shaped circumcoronal radiolucence with a sclerotic border over lower 3rd molar. Dentigerous cyst usually surrounds the crown of the tooth. The precise measurement of the cyst is difficult, but its radiolucent space surrounding the tooth crown should be at least 3mm to 4mm. Dentigerous cyst is one of the most aggressive odontogenic cyst. Keep growing cyst makes bone expansion. That makes face asymmetric, displaces the involved tooth for a considerable distance, and even causes root resorption of adjacent erupted teeth. Sometimes more severely, can make all ramus to coronoid process and condyle areas have a hollowing-out phenomenon.



Features:

  • Most common odontogenic cyst, next to radicular cyst

  • It arises in the follicular region of unerupted permanent tooth.

  • It develops after fluid accumulates between the remnants of enamel organ and the tooth crown.

  • Usually adolescents, 20-40 years old. There is a slight male predilection, the prevalence is higher for whites than for blacks.

  • Most common sites: mandibular third molar, maxillary canine, maxillary third molar.

  • Unilocular radiolucency, well-defined, often corticated, associated with the crown of an unerupted and displaced tooth.

  • Large cysts tend to expand the outer plate (usually buccally)

  • Eruption cyst is a term to describe a dentigerous cyst in children when it is situated in the soft tissues overlying the unerupted tooth.

  • Effects on adjacent tooth

  • Treatment

  • Progonosis

  • Ameloblastic change (neoplastic transformation) may occur in the odontogenic epithelial cyst lining.


Differential diagnosis

Mural ameloblastoma

  • It arises from the wall of a pre-existing cyst (most commonly from a dentigerous cyst)

  • Most common site: Mandible posterior region.

  • Pericoronal radiolucency associated with an unerupted displaced tooth (usually mandibular 3rd molar).

  • It may cause root resorption of the adjacent teeth and buccal/lingual expansion.


Adenomatoid Odontogenic Tumor (AOT)

  • Benign. Relatively rare.

  • It occurs in young patients (70% of cases in patients younger than 20 years).

  • Most common site: anterior maxilla.

  • Often surrounds an entire unerupted tooth (most commonly the canine).

  • Usually well defined, well corticated. Some tumors are totally radiolucent


Differential diagnosis

Ameloblastic fibroma

  • Benign. Rare.

  • Occurs in children and adolescents.

  • Most common site: mandible posterior region.

  • Often associated with an unerupted tooth.

  • Well defined, well corticated. Small lesions are monolocular. Large lesions are multilocular.

  • It may cause displacement of adjacent teeth. Large lesions cause buccal/lingual expansion.


Paradental cyst

Cyst of uncertain pathogenesis, arising in relation to a partly erupted vital tooth involved by pericoronitis (usually lower 3rd molar).


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