Panoramic X-ray Detects Tumor in Patient
AGAN, ST. PAUL AND MINNEAPOLIS, MINNESOTA – Different types of X-rays can make a huge difference in detecting abnormalities, and that point recently was confirmed with one of St. Paul Incognito braces expert Dr. Jennifer Eisenhuth’s patients.
Eisenhuth, an Eagan and St. Paul braces provider, took a panoramic X-ray of a 12-year-old female patient’s teeth as part of a routine check-up prior to initiating orthodontic treatment and detected an aggressive dentigerous cyst that had gone undetected by the patient’s family dentist.
The patient had a baby tooth that should have already fallen out, so Eisenhuth took the X-ray to see why it was still intact and not loose, said the St. Paul Invisalign expert. That is when she saw the cyst and noticed it had pushed the patient’s mandibular wisdom tooth to the wall of her jaw- toward her jawline and her second molar was pushed into her first molar.
“I have not seen a cyst before of this size and aggressiveness,” she said.
The cyst, which looks like a big, black balloon with a white shell, basically is full of air and mucus, and had eaten away much of the left side of her mandible. However, it had caused no pain or discomfort for the patient. In fact, the cyst had caused no symptoms at all.
Eisenhuth referred the patient to a surgeon.
“He was a bit worried because her mandible was just a shell,” Eisenhuth said. “For that reason, the surgery to remove the cyst was done in an operating room, rather than his office. He was concerned about a possible fracture of the mandible during the removal of the cyst.”
A dentigerous cyst- also called a Follicular Cyst- is an odontogenic cyst associated with a partially erupted or unerupted tooth. Some experts believe that the forces of an erupting tooth may cause the cyst, Eisenhuth said.
Dentigerous cysts can grow to be quite large and can even cause tooth movement, but it is more common for them to remain small, according to information on the topic posted on exodontia.info. Although it is common for a person to experience no symptoms from the cyst, it actually can be quite dangerous, in that these systs can increase a person’s risk of fracturing his/her jaw.
There are a couple of reasons why the cyst may have gone undetected by the patient’s family dentist, said Eisenhuth, who owns an Eagan and St. Paul orthodontics practice.
“Because these cysts can grow quickly, it isn’t surprising that the family dentist wouldn’t have noticed it,” she said. “This cyst could have grown over the last six to twelve months, and a patient would normally see their dentist every six months.”
This patient’s cyst grew as her third molar developed.
Another reason for going undetected prior to her appointment with Eisenhuth is due to the type of dental X-rays dentists take, versus those used by orthodontists. Most family dentists take bite-wing X-rays, which are views of the biting surfaces of the teeth that show whether any cavities exist between the teeth.
Orthodontists, on the other hand, primarily take panoramic X-rays of the upper and lower jaws. This type of X-ray offers a two-dimensional view of a half-circle from ear to ear.
Panoramic X-rays give a great overall view, but are not so great with details such as showing tooth decay, said Eisenhuth, who also is a St. Paul orthodontist. A dentist typically would want an X-ray that would show those types of details.
“At the end of the day, we are elated that we detected the tumor,” Eisenhuth said. “The patient’s surgery went well, and we are confident that soon we will be able to begin the patient’s orthodontic treatment, which will be successful.”
Eisenhuth added that the surgeon believed the cyst to be benign, but a biopsy will confirm that. If it is benign, the bone will heal and fill the cyst space quickly- probably within four to six weeks.
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