Removing complex teeth safely and with minimal impact.
Dentigerous cysts are fluid-filled, expansile lesions that can form around unerupted teeth. In our experience, these cysts can affect any breed of dog, but brachycephalic breeds (such as Pugs, French Bulldogs and Boxers) and small breeds like Chihuahuas are most commonly affected.
The mandibular first premolar teeth are the most frequently impacted/unerupted. If left untreated, these cysts can expand significantly, causing extensive damage to surrounding teeth and bone and potentially leading to pathologic jaw fractures. They may become quite large before any external signs are noticeable.
Managing Missing Teeth & Dentigerous Cysts
Patients with missing teeth should ideally have these areas examined with dental radiographs. This early detection allows for identifying unerupted teeth when cysts are small, leading to less invasive treatments.
If a dentigerous cyst is found, it is essential to not only extract the unerupted tooth but also meticulously debride and remove the cyst wall lining. Any remaining lining could lead to recurrence and the need for repeat surgery, though this is rare. For this reason, follow-up radiographs are recommended 6 months after treatment to confirm complete resolution.
Management & Diagnosis of Dentigerous Cysts
In many cases, extraction of neighbouring teeth is necessary when a cyst has significantly expanded and affected the roots of adjacent teeth. Resorption of these tooth roots may occur, sometimes requiring extensive surgery for large cysts. The full extent of damage is often only visible through dental radiographs.
Although dentigerous cysts are benign and typically have a classic radiographic appearance, other lesions can present similarly, and there is a rare risk of transformation into malignant tumours. Therefore, we usually send a sample of the cyst lining to a pathologist for further assessment to confirm the diagnosis. If malignancy is detected, additional surgery would generally be required.
Post-Operative Management & Early Detection
Wound breakdown can occur post-operatively, particularly with extensive lesions. When this happens, the surgical site may need to be managed as an open wound, and in severe cases, repeat surgery might be required.
Dentigerous cysts associated with unerupted teeth are relatively common in pets. Early detection and treatment are preferable to avoid more extensive and invasive surgeries. Since pets rarely show clinical signs and cysts often grow quite large before becoming visible, radiographs are recommended when a tooth is missing. This helps in the early detection and treatment of the condition.
