Cisto dentígero inflamatório relacionado a dente permanente:
considerações etiopatológicas

Silveira, Vanessa Ávila Sarmento; Pereira, Andresa Costa; Amadei, Susana Ungaro; Carmo, E.D.; Carvalho, Y.R.

Artigo Original

Cisto dentígero inflamatório relacionado a dente permanente: considerações etiopatológicas

Inflammatory dentigerous cysts involving permanent teeth: etiopathologic considerations

Silveira, Vanessa Ávila Sarmento; Pereira, Andresa Costa; Amadei, Susana Ungaro; Carmo, E.D.; Carvalho, Y.R.

Rev. odontol. UNESP, vol.38, n3, p.143-147, 2009

PDF

Downloads: 23

Resumo

Na rotina laboratorial, casos diagnosticados clinicamente como cisto dentígero, envolvendo a coroa de um dente permanente incluso, podem apresentar achados histopatológicos compatíveis com cisto odontogênico inflamatório. O objetivo deste estudo foi discutir a etiopatogenia de lesões clínicas compatíveis com cisto dentígero que apresentam aspectos histopatológicos de cisto inflamatório. Para tanto, foram selecionados cinco cistos associados a dente permanente incluso, com características inflamatórias ao exame microscópico, sendo os dados tabulados e analisados. A idade dos cinco pacientes – quatro leucodermas e um xantoderma – variou entre 16 e 50 anos, com média de 34,6; em relação ao gênero, quatro pacientes homens e uma mulher; quanto à localização dos cistos, quatro ocorreram na mandíbula e apenas um na maxila. Histopatologicamente, todos os casos exibiam fragmentos de lesão cística e eram parcialmente revestidos por epitélio pavimentoso estratificado não queratinizado. Em todos os casos, havia imagem radiolúcida envolvendo a coroa de dente incluso e alterações radiográficas adjacentes, sugestivas de processo infeccioso. Baseando-se na literatura e nas características dos cinco casos apresentados, sugere-se que um processo infeccioso pode ser capaz de originar uma variante inflamatória do cisto dentígero, com aspectos histopatológicos semelhantes aos de um cisto odontogênico inflamatório.

Palavras-chave

Cisto dentígero, cistos odontogênicos, inflamação

Abstract

In laboratory routine, cases clinically diagnosed as dentigerous cysts involving the crown of unerupted permanent tooth may present histopathologic findings compatible with an inflammatory odontogenic cyst. The aim of the present study was to discuss the etiopathogenesis of clinical lesions compatible with dentigerous cysts that present histopathological features of an inflammatory cyst. Five cases of cysts associated with unerupted permanent tooth presenting inflammatory characteristics upon microscopic examination were selected, and the data were tabulated and analyzed. Four of the five patients were white and one was Asian, with age ranging from 16 to 50 years (mean of 34.6 years). Four patients were males. Four cysts were located in the mandible and only one in the maxilla. Histopathologically, fragments of a cystic lesion partially lined with nonkeratinized stratified pavement epithelium were observed in all cases. In all cases, there was a radiolucent image involving the crown of the unerupted tooth and adjacent radiographic alterations, suggesting an infectious process in the neighboring region. Based on the literature and the characteristics of the five cases reported here, we suggest that an infectious process may give origin to an inflammatory variant of dentigerous cysts with histopathologic features similar to those of inflammatory odontogenic cysts.

Keywords

Dentigerous cyst, odontogenic cyst, inflammation.

Referências

1. Al-Talabani NG, Smith CJ. Experimental dentigerous cysts and enamel hypoplasia: their possible significance in explaining the pathogenesis of human dentigerous cysts. J Oral Pathol. 1980; 9:82-91.

2. Regezzi JA, Sciubba JJ, Jordan RCK. Cysts of the jaw and neck. In: Regezzi JA, Sciubba JJ, Jordan RCK. Oral pathology: clinical pathologic correlations. St. Louis: Saunders Elsevier; 2008. p. 237-59.

3. Waldron CA. Odontogenic cysts and tumors. In: Neville BW, Damm DD, Allen CM, Bouquot JE. Oral and maxillofacial pathology. Philadelphia: Saunders; 2002. p. 589-609.

4. Aguilo L, Gandia JL. Dentigerous cyst of mandibular second premolar in a five-year-old girl, related to a nonvital primary molar removed one year earlier: a case report. J Clin Pediatr Dent. 1998; 22:155-8.

5. Benn A, Altini M. Dentigerous cysts of inflammatory origin. A clinicopathologic study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996; 81:203-9.

6. Da Silva TA, De Sá AC, Zardo M, Consolaro A, Lara VS. Inflammatory follicular cyst asociated with endodontically treated primary molar: A case report. J Dent Child. 2002;69:271-4.

7. Toller PA. The osmolality of fluids from cysts of the jaws. Br Dent J. 1970;129:275-8.

8. Godoy GP. Cisto dentígero inflamatório: uma nova entidade? Rev Bras Patol. 2004;3:48-9.

9. Azaz B, Shteyer A. Dentigerous cysts associated with second mandibular bicuspids in children: report of five cases. J Dent Child. 1973;40:29-31.

10. Colgan CM, Henry J, Napier SS, Cowan CG. Paradental cysts: a role for food impaction in the pathogenesis? A review of cases from Northern Ireland. Br J Oral Maxillofac Surg. 2002; 40:163-8.

11. Philipsen HP, Reichart PA, Ogawa I, Suei Y, Takata T. The inflammatory paradental cyst: a critical review of 342 cases from a literature survey, including 17 new cases from the author´s file. J Oral Pathol Med. 2004;33:147-55.