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Jueves, 12 Septiembre 2019 17:04

217 - Third molar pericoronary sac increase

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An 18 years old male patient goes to Maxillofacial Diagnostic Institute for evaluation of third molars for reasons of exodontics.

The evaluation of panoramic radiography shows fixed appliances for orthodontics in the upper jaw, slight dental crowding of the anterior inferior sector, absence of piece 21 and third molars retained and impacted. The most prominent being the pericoronary radiolucent image associated with the distal face of piece 48, which is rounded, with defined limits and corticalized edges. (Figure 1)

In the volumetric conic tomography, we confirm the entity previously described, in addition, a commitment of lingual bone table is visualized with a volumetric measurement of 0.08 mm3 and with an origin at the level of the cervical area. (Figure 2, Figure 3 and Figure 4).

In 3D reconstructions the previously described illustratively as well as its impact with adjacent bone and dental structures is evidenced. (Figure 5, Figure 6 and Figure 7)


Follicular hyperplasia vs cystic lesion in formation


Pericoronary sacs are part of the immature structures that make up the ectomesenchymal portion of dental germs.

It is composed of fibrous connective tissue and often contains epithelial residues of odontogenesis, which could be the starting point of some pathology. Radiologically, it appears as a thin pericoronal radiolucent image considered normal by some authors when it is less than 3 mm thick and by others when it is not thicker than 2.5 mm.

However, multiple odontogenic lesions (cystic and tumor lesions) in an early stage cannot be distinguished from a simple follicular hyperplasia, which is why it is indicated to perform a histopathological analysis of pericoronary tissues after performing a procedure surgical.


Research Team IDM

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