Radiographic evaluation of dentigerous cyst with cone beam CT

The purpose of this study was to accurately analyze the radiographic characteristics of dentigerous cyst (DC) with multiplanar images of cone beam computed tomography (CBCT). Thirty eight radiographically and histopathologically proven cases of DCs were analyzed with panoramic radiograph and CBCT, retrospectively. The radiographic CT pattern, symmetry of radiolucency around the unerupted tooth crown, ratio of long length to short length, degree of cortical bone alternation, effects on adjacent tooth, and cyst size were analyzed. Relative frequencies of these radiographic features were evaluated. In order to compare the CBCT features of DC with those of odontogenic keratocyst (OKC), 9 cases of OKCs were analyzed with the same method radiographically. DCs consisted of thirty unilocular cases (79.0%), seven lobulated cases (18.4%) and one multilocular case (2.6%). Eight were asymmetric (21.0%) and thirty were symmetric (79.0%). Maxillary DC showed rounder shape than mandibular DC (L/S ratio; maxilla 1.32, mandible 1.67). Alternations of lingual cortical bone (14 cases, 48.2%) were more frequent than those of buccal side (7 cases, 24.1%). CBCT images of DC showed definite root resorption and bucco-lingual tooth displacement. These findings were hardly observed on panoramic radiographs of DCs. Comparison of CBCT features of DC with those of OKC showed several different features. CBCT images of DC showed various characteristic radiographic features. Therefore, CBCT can be helpful for the diagnosis of DC radiographically.