Patient, male, 12 years old, with no relevant medical-surgical history, consultation for pain and recurrent volume increase in the right zone, of firm consistency, without fluctuation, painful to mandibular apex.
The patient also presented lymphadenopathy in ipsilateral submandibular ganglia and sustained mouth opening.
Intraoral examination revealed mixed dentition second phase, lack of eruption of teeth 3.7 and 4.7, with increased vestibular volume and crystalline exudate in the area of tooth 4.7.
In the panoramic radiograph, the 4.7 tooth is observed in late extraosseous evolution, in mild mesioversion, with increased pericoronary space.
A cone beam computed tomography scan for the jaw was requested.
Teeth 4.7 was observed in extraosseous course, in mild mesioversion, with presence of extensive hypodense buccal area and expansion of buccal bone table.
Similarly, as an imaging finding, tooth 3.7 is observed in intraosseous evolution, in mild mesioversion and linguoversion, with presence of hypodense vestibular area.
In a surgical procedure under local anesthesia of the bilateral inferior alveolar nerve, both lesions are treated with a linear flap with distal discharge to avoid periodontal defect in teeth 3.6 and 4.6.
A pseudocrystalline colored cystic content was observed.
Bilateral cystic enucleation, surgical aseum and 4.0 nylon suture were performed.
In the histopathological analysis of the cystic lesion, fragments of fibroconnective tissue arranged as wall-shaped are observed, partially rectified by a stratified plane epithelium, in which collagen fibers are present.
These fibers, mostly mature and in other more lax areas, are associated with small islets of odontogenic epithelium, a mild and diffuse lymphocytic inflammatory infiltrate and some blood capillaries.
Histopathological findings suggest a thickened and inflamed pericoronary sac compatible with MBQ.
Post-surgical control was performed 10 days after surgery and removal of suture, absence of fistula in relation to tooth 4.7.
At 8 months there was no increase in vestibular volume and pain.
The control panoramic radiograph showed the tooth 3.7 in extraosseous evolution, in mild mesioversion, and tooth 4.7 in extraosseous evolution, close to the occlusal plane both sides, with a correct healing.
