This 11 year old border collie has a swelling associated with the mucosa and gingiva on the mesial aspect of the left maxillary canine tooth.
Describe what you see radiographically
A radiographic lucency is present mesial to the canine tooth root extending rostrally toward the third incisor. What is your #1 rule out?
Although neoplasia should be considered the most likely rule out would be a cyst. This is based on the distinct lucency with smooth well defined borders at the dorsal extent of the lucency. Exposure of the tooth supports significant destruction adjacent to the canine involving the vestibular bone. The cystic structure extended to the palatal aspect of the canine, necessitating extraction for complete visualization and removal of cystic lining.
The entire cystic lining was removed after extraction of the canine tooth. The bone was smoothed with a tapered diamond, 17% EDTA ulitized on the root surface of the incisor and bone graft particulate placed adjacent to the incisor. The intention is to generate tissue growth and save the incisor tooth. Extraction of this tooth is also an option.
Radiograph showing complete removal of the canine and post-bone contouring.
Osteoconductive material is placed. What is the likely origin of this cyst?
Closure of the area is accomplished with absorbable simple interrupted suture. Histopathology confirmed the diagnosis of a cyst. The epithelial cell rests of Malassez are remnants of the germinal tissue responsible for root formation. Cell rests of Serres are remnants of dental lamina epithelium entrapped within the gingiva. Either of these cell types may be spontaneously activated to result in cyst production.