Third molar cysts

[Brad Potter]

Don:

During my training at San Antonio, we were taught the following criteria (and I generally use the same-certainly considered on a case-by-case basis):

If the follicular space excedes 3 mm (on a panoramic radiograph) or 2.5 mm (on a periapical film) in any location around the tooth, we should consider cystic degeneration or some other pathology.

Brad Potter

>>> Don_Tyndall at DENTISTRY.UNC.EDU - 2/7/01 3:27 PM >>>
Colleagues,

I have a friend who is an oral surgeon who is involved as an expert witness
in a malpractice case involving third molar surgery with resultant
parasthesia.  The surgeon is arguing that the tooth needed to come out based
on widening of the follicular space around impacted tooth (indicating
suspicion of cystic degeneration or cyst formation).  My friend will be
asked "how wide is wide enough to be suspicious".  He is not quite sure how
to answer. I know standard of care can be a very local issue but was
wondering if anyone had any thoughts regarding the question of when a
follicular space widens enough to be considered as a potential cyst.
Personally I have seen a few "cysts" that turned out to be hyperplastic
follicles. I would appreciate anyone's opinion on this issue. Thank you.

Don Tyndall



Donald A. Tyndall DDS, MSPH, PhD
Professor, Diagnostic Sciences and General Dentistry
Director of Radiology
UNC-CH School of Dentistry
Phone: (919)966-2746
Fax: (919)966-0705
email: Don_Tyndall at dentistry.unc.edu