A 28-year-old male patient presented with left hemimandible pain and fever.
There was no relevant pathological history.
Physical examination did not reveal any specific symptoms, but there was pain due to palpation of the pericoronary tissues of the lower left third molar.
Emergency laboratory tests showed a slight increase in the number of leukocytes, with no other remarkable alteration.
The orthopantomography (OPG) shows both third molars included in mesioangular position, with follicular sacs being the largest right.
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With the suspicion of possible infection of odontogenic cause (pericoronaritis) antibiotic treatment is established, with complete resolution of the clinical picture.
Extraction of both lower cords is recommended.
The histological study confirmed the presence of a follicular sac associated with the cord, formed by non-keratinized polystratified epithelium.
After extraction of the left lower third molar, the patient does not come to complete the treatment.
After 20 months she consulted again for pain in the right lower third molar.
A large radiolucent image around the right inferior chordal crown was observed in the OPG.
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With the diagnostic suspicion of dentigerous cyst associated with third molar surgery was performed with extraction of the piece and cystectomy.
The anatomopathological study confirmed the presumptive diagnosis as a lesion with connective tissue wall lined inside by a stratified epithelium of keratinized ciliary cells and abundant mucinous cells.
In the three-month follow-up, an adequate process of active ossification (with formation of bone trabeculae) of the residual cavity generated by the cyst was observed.
