Dentigerous Cyst Crossing The Midline Associated With Multiple Inverted Supernumerary Teeth And Impacted Permanent Tooth: A Case Report

Sudhir Shrestha, Zhang HongYi


Dentigerous cysts are the second most common odontogenic cysts after radicular cysts and are most commonly seen in association with the third molar region of the mandible, followed in frequency by maxillary canine, maxillary third molar, and rarely in relation to maxillary central incisor. Dentigerous cysts are the most common developmental cysts of the jaws. Dentigerous cysts around supernumerary teeth, however, account for 5% of all dentigerous cysts, with most developing around a mesiodens in the anterior maxilla. This article reports a rare and unusual case of a dentigerous cyst of the anterior maxilla involving a multiple inverted mesiodens with permanent impacted tooth with midline crossing. The complications associated with inverted mesiodens include eruption disturbance of adjacent teeth, displacement & rotation of the central incisors, diastema, root resorption, abnormal occlusion, cyst formation or nasal eruption of the mesiodens. Early detection and timely surgical intervention of inverted mesiodens is crucial to prevent unwanted consequences.  A provisional diagnosis of infected odontogenic cyst was made. Histopathological examination confirmed the diagnosis of infected dentigerous cyst.  The patient was treated surgically by enucleation of total cyst and surgical extraction of multiple inverted mesiodens and permanent central incisor under general anesthesia.


dentigerous cyst, inverted tooth , midline crossing, multiple supernumerary tooth

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