Third molar cysts

[Laurie Carter]

As usual, classifications change (sometimes just to make us crazy keeping up with it it seems!)
It is important to view primordial cysts as a totally separate entity than dentigerous cysts as the former demonstrate a very high incidence (40%) of transforming histologically into odontogenic keratocysts, which changes the nature of the beast entirely into a much more aggressive picture.

As to a previous ? by Allan and Axel, there really is no distinction histologically between a normal dental follicle and a dentigerous cyst. You're still dealing with reduced enamel epithelium. You still have no rete pegs, should have no inflammation. Some people have looked at well,is the reduced e.e. getting thicker or columnar etc, but that hasn't born any fruit. At most, if the lining shows clear cells, then you know it's a cyst. The distinction is really a clinical one - i.e., do you have a pathologically widened follicular space. So we're back to the chicken/egg debate.
Laurie Carter