A 6-year-old male visited a pediatric dentist for a checkup. Oral examination revealed a soft, bluish swelling on the facial gingiva.
Joen Iannucci Haring, DDS
History
The patient`s mother was unaware of the swelling, and she stated that the child did not complain of symptoms in the area. The patient had previously seen a general dentist for regular dental examinations and routine restorative dental treatment.
At the time of the dental visit, the patient appeared to be in an overall good state of health. No significant problems were noted during the medical history, and no medications were being taken by the patient at the time of the dental examination.
Examinations
No unusual or abnormal findings were identified during the extraoral examination. Intraoral examination revealed a mixed dentition. On the facial aspect of the gingiva between the right maxillary canine and central incisor, a blue swelling was noted (see photo). The lesion was soft and fluctuant.
Further examination of the oral soft tissues revealed that no other abnormalities were present.
Clinical diagnosis
Based on the clinical information presented, which of the following is the most likely clinical diagnosis?
- mucocele
- parulis
- gingival cyst
- eruption cyst
- dentigerous cyst
Diagnosis
__ eruption cyst
Discussion
The eruption cyst is a common soft tissue lesion that is analogous to the dentigerous cyst (RDH May 1990) found in bone. As the term eruption suggests, this soft tissue cyst is always seen in association with an erupting tooth.
The eruption cyst develops when the dental follicle separates from an erupting tooth and fluid or blood accumulates in the follicular space. The cause of this developmental lesion is unknown.
Clinical Features
The eruption cyst is associated with deciduous or permanent teeth. It typically occurs in children under 10 years of age. Although it is most common in the mandibular molar region, the lesion may occur with any erupting tooth.
Clinically, the eruption cyst appears as a well-circumscribed bluish swelling of the gingival mucosa above the site of an erupting tooth. The lesion is soft and fluctuant. If the eruption cyst is traumatized, blood may occur in the cystic fluid which imparts a purplish or deep blue color. In such cases, it is referred to as an eruption hematoma.
Diagnosis
The diagnosis of an eruption cyst is based on the characteristic clinical presentation of the lesion. Rarely is a biopsy required to establish a definitive diagnosis.
Treatment
No treatment is required for the eruption cyst. In most instances, the tooth erupts without complication and the cyst ruptures. However, in some cases, the simple excision of the cyst roof may be necessary to facilitate eruption.
Joen Iannucci Haring, DDS, MS, is an associate professor of clinical dentistry, Section of Diagnostic Services, The Ohio State University College of Dentistry.
