Discrepancy in diagnosis and characteristics of odontogenic cystic lesions in mixed dentition period; a retrospective study

Background

There is an ambiguity in the correct diagnosis of odontogenic cystic lesions in mixed dentition period. So, present study was planned to assess diagnostic discrepancies and their potential impact on treatment strategies in pediatric odontogenic cysts.

Material method

The data of the patients was retrieved from the digital records of patients from January 2014 to January 2024. After screening of the digital records, 61 cases were selected for screening, for demographic details, various clinical characteristics, radiographic investigations (OPG, CBCT etc.). For the calculation of the discrepancy between clinical and histopathological diagnosis of the radicular cyst, dentigerous cyst, and odontogenic kerato-cyst the Discrepancy Index was calculated.

Results

The results revealed that 61 cases of various cystic conditions were identified. Among them, the dentigerous cyst constituted 14.7 % (9cases), radicular cyst constituted 42.6 % (26cases), and Odontogenic kerato-cyst constitutes 27.86 % (17 cases) with the mean age (in years) of reporting 9.55 ± 3.16, 9.00 ± 2.79, and10.06 ± 2.43 respectively. The odontogenic cysts were commonly found in mandibular posterior region. In patients with dentigerous cysts, 44.44 % had a history of extraction of primary teeth, 55.55 % had decayed/pulpectomised teeth. Among them the maximum discrepancy index was observed between dentigerous cysts and Odontogenic kerato-cysts i.e., 50 %, followed by radicular cyst and dentigerous cyst or vice-versa (21.42 %).

Conclusion

Despite the difficult diagnosis of dentigerous cyst, radicular cyst and OKCs in mixed dentition, cystic lesions should be examined thoroughly and diagnosed carefully. Misinterpreting a cyst as a tumor, could lead to aggressive surgical intervention when a less invasive approach would suffice.