Dentigerous Cyst with Oral Antral Fistula

Findings:

A large expansile lesion with multiple bone interruptions and dehiscence of the left maxillary floor is associated with the crown of an unerupted tooth. A large air fluid level is present within the lesion. Otherwise mild mucosal thickening is present in the paranasal sinuses.

Discussion:

When an expansile lesion of the mandible or maxilla is detected, relation to an adjacent tooth should be excluded first. If the cystic lesion is associated with the roots of an erupted tooth, a chronic infectious periapical cyst should be considered first. If the cystic expansile lesion is associated with the crown of an unerupted tooth, a dentigerous cyst should be considered. The presence of gas within this cystic expansile lesion indicates a communication to the oral cavity with superinfection.

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