Dentigerous cyst with parietal and intracystic calcification
This study, published in the Journal of Clinical and Experimental Dentistry, presents a clinical case of a 34-years old man with a pericoronal radiolucent lesion associated to an impacted lower third molar with the presence of radiopaque material inside.

A 34-years old man presented for a routine check-up. The OPG revealed an included right lower third molar associated to a pericoronal radiolucency with a radiopaque area inside. Interestingly, a periapical radiograph from this area taken 10 years ago showed no lesion. A cyst or a benign odontogenic lesion was suspected.

A CT-scan displayed an area of bone resorption on the alveolar ridge, a thinning of the cortical bone, bone sclerosis on the distal area and the presence of a small radiopaque piece near to the occlusal aspect of the third molar. The surgical intervention was made under local anesthesia by a direct troncular technique to anesthetize inferior alveolar and lingual nerves, and an anesthetic infiltration on the buccal side and the retromolar mucosa for the buccal nerve.

The complete enucleation of the lesion was done and a turbid liquid and a small piece of hard tissue emerged from the inside. Subsequently, the extraction of the third molar was made maintaining the integrity of the neurovascular bundle of inferior alveolar nerve located lingually. Finally, the wound was sutured with 3/0 silk.

Microscopically, a cystic wall constituted by fibrous connective tissue was observed. Interestingly, some basophilic globular calcified ovoid deposits were seen into its thickness. Furthermore, some of these had a greater size and presented a cemento-osseous structure with apposition lines and included cells. Some capsular deposits showed a non-keratinized stratified thin epithelial lining, focally detached. The histopathological diagnosis was dentigerous cyst with capsular calcifications.

Read more here: