Pericoronal radiolucencies

Question 1

Pericoronal Radiolucencies That do or do not Contain Radiographic Flecks?
• Normal Follicular Space
• Pericoronitis
• Dentigerous Cyst
– Ameloblastoma
– Squamous cell carcinoma
• Eruption Cyst
• Ameloblastic Fibroma

Answer 1

do not

Question 2

Pericoronal Radiolucencies 
That may or may not Contain Radiopaque Flecks?
• Ameloblastic Fibro-odontoma
• Odontoameloblastoma
• Adenomatoid Odontogenic 
Tumor
• Calcifying Epithelial 
Odontogenic Tumor
• Calcifying Odontogenic Cyst

Answer 2

May

Question 3

• Remnant of dental follicle adjacent a
developed crown of an unerupted or
impacted tooth should be no greater
than;

Answer 3

Follicular Space

Question 4

• If dental follicle gets 
infected, the 
inflammation often 
spreads along the 
deep fascial planes

Answer 4

Pericoronitis

Question 5

• The diagnosis must be based on 
evidence of pericoronal tissues, 
and the  clinical signs and 
symptoms of disease
• Edematous, erythematous mucosa; 
pain; fever; malaise, etc...  
• Cellulitis to fascial plane deep 
spaces causing dramatic facial 
swelling
-Major clinical signs; not much radiographic signs
-Most likely reason why 3rd molars are removed

Answer 5

Pericoronitis

Question 6

_____ is the most common cyst in the jaw of odontogenic origin

Answer 6

Periapical cyst

Question 7

_____ is the 2nd most common cyst in the jaw of odontogenic origin

Answer 7

Dentigerous cyst

Question 8

Cystic lining arises from 
remnants of dental 
follicle
Accounts for 20% of jaw 
cysts

Answer 8

Dentigerous cyst

Question 9

Radiographic
• Consistently 
widened follicular 
space of >3.0mm
• Well-delineated 
radiolucency with 
corticated borders

Answer 9

Dentigerous cyst

Question 10

What can dentigerous cysts degenerate into?

Answer 10

Ameloblastoma

SCC

Question 11

• Presents as a soft fluid-filled swelling of
crestal mucosa in area of an erupting
tooth
• Often has bluish coloration due to trauma
creating blood in cystic fluid

Answer 11

Eruption cyst

Question 12

Radiographic
May see lack of 
crestal alveolar bone 
because of position 
of erupting crown 
and cyst near crest

Answer 12

Eruption cyst

Question 13

Where are the most common areas for eruption cysts?

Answer 13

Mand molars

Question 14

Where are the most common areas where dentigerous cysts occur?

Answer 14

Max canines

Mand 3rd molars

Question 15

Where is an ameloblastic fibroma most likely found?

Answer 15

Mand posteiror

Question 16

A mixed odontogenic tumor
Radiographic
A pericoronal radio-
lucency associated 
with a developing 
tooth
Younger individuals

Answer 16

Ameloblastic fibroma

Question 17

A mixed odontogenic tumor, similar to 
ameloblastic fibroma but has a mineralized 
stroma
If mineralization is high, then radiopaque 
flecks may be evident radiographically
Radiographic
Pericoronal radio-
lucency associated 
with a developing 
tooth
Radiopaque flecks 
noted in the lumen
Must be differentiated from the 
odontoameloblastoma as the latter is more 
aggressive.

Answer 17

Ameloblastic fibro-odontoma

Question 18

Must be differentiated from the ameloblastic
fibro-odontoma, as it is more aggressive
and requires surgical resection
Radiographic
Expansive with destruction of adjacent bone
Rudimentary tooth-like structures similar to
complex odontoma
Resection is tx

Answer 18

Odontoameloblastoma

Question 19

Histologically a cross between a 
dentigerous cyst and ameloblastoma
Odontogenic epithelium is arranged in duct-
like glandular array
Radiographic
• Consistently widened 
follicular space of 
>3.0mm if associated 
with crown of 
impacted tooth (75% 
of cases are 
pericoronal).
• Well-delineated 
radioluceny with 
corticated border, 
usually >3.0cm.
Seen in adolescent females likely in the anterior maxilla
-Enucleation is TX

Answer 19

Adenomatoid Odontogenic Tumor

Question 20

A breakdown product 
of the neoplastic 
epithelial cells;  these 
mineralizations are 
called

Answer 20

Leisegang’s

rings

Question 21

Approximately 50% occur in association with 
impacted teeth.
Radiographic
• Radiopaque flecks are 
due to calcified 
amyloid
• A breakdown product 
of the neoplastic 
epithelial cells;  these 
mineralizations are 
called Leisegang’s 
rings
Age
Mean age of 40 years
Site
Mandible:Maxilla is 2:1
More likely in posterior mandible
Need Resections

Answer 21

Calcifying Epithelial Odontogenic Tumor

Lindberg Tumor

Question 22

• Extremely variable presentation
• Approximately 2-16% behave as 
neoplasms
• Present from 2.0-4.0cm diameter; as large 
as 12cm
Radiographic
• Vary from uni to 
multilocular
• 50% have 
radiopacities in the 
lumen
• 33% present as 
pericoronal 
radiolucencies
Age
Occur at any age but majority diagnosed in 
teens and young adults
Site
65% in anterior maxilla
Sex
No predilection
Simple enucleation with minimal 
recurrence

Answer 22

Calcifying Odontogenic Cyst

Gorlin cyst