Dentigerous Cyst Associated With Impacted Inverted Mesiodens: A Report of Three Cases and a Brief Literature Review

Abstract

Introduction: Dentigerous cysts are the second most prevalent type of odontogenic cyst, following radicular cysts, and are primarily associated with impacted teeth. These cysts are most commonly associated with impacted third molars and canines. Notably, approximately 5% of dentigerous cysts are found in conjunction with supernumerary teeth, predominantly mesiodens. Between 1964 and April 2025, only about 51 cases of dentigerous cysts related to impacted mesiodens have been reported in the literature. This article presents three additional cases, accompanied by a concise literature review. Case Presentation: This report outlines three clinical cases managed in the Oral and Maxillofacial Surgery Outpatient Department. The first case concerns a 31-year-old male who presented with a cystic swelling in the labial vestibule of the maxilla, which had persisted for 2 months. The second case involved a 25-year-old male who reported swelling in the anterior hard palate, which had been present for 6 months. The third case featured a 22-year-old male who complained of pain associated with the upper left central incisor for 1 month. Comprehensive clinical examinations and radiographic evaluations in all cases revealed cystic lesions associated with impacted inverted mesiodens. Surgical intervention was performed through enucleation of the cysts and extraction of the impacted mesiodens. Histopathological analysis confirmed the diagnosis of dentigerous cysts. Postoperative recovery was uneventful for all patients, with no complications recorded during a 1-year follow-up. Discussion: Radiographically, dentigerous cysts typically appear as unilocular radiolucent lesions surrounding the crown of an impacted tooth, with the cyst attached at the cementoenamel junction. The standard treatment approach involves enucleation of the cyst and extraction of the associated impacted tooth. Conclusion: Dentigerous cysts associated with impacted inverted mesiodens should be considered in the differential diagnosis of anterior maxillary swelling. Timely diagnosis and surgical intervention are critical for achieving optimal patient outcomes and mitigating potential complications.