1032H
Fig. 15.16 Radiographic appearance of a dentigerous cyst associated with a lower
second premolar. (By kind permission of Dental Update.)
15.3.2 Developmental conditions
Numerous developmental conditions may affect the oral and perioral structures. These
range from minor problems (e.g. tongue-tie) that are readily treated under local
anaesthesia, to severe craniofacial disorders (e.g. Crouzon's syndrome) requiring a
combined interdisciplinary approach between maxillofacial and neurosurgery.
Readers should refer to specialized texts for a full description of congenital jaw
abnormalities. It is important to remember that patients with developmental orofacial
abnormalities may have other congenital disorders, such as cardiac defects, which
may influence routine dental treatment.
15.3.3 Osteodystrophies
FIBROUS DYSPLASIA
This can occur as one of three variants, namely: monostotic, polyostotic, or as part of
Allbright's syndrome (where associated conditions include skin pigmentation and
precocious puberty in females). The monostotic type is the most common to affect the
jaws, especially the maxilla. The disease presents as a slow-growing bony expansion
that produces facial asymmetry and malalignment of teeth. Radiographically there is a
fine granular radiopacity (1033HFig. 15.17). Surgery can correct the asymmetry.
CHERUBIM
In this rare condition there is a characteristic fullness of the cheeks and jaws. Initial
presentation is commonly between 2 and 4 years of age. Size increases during growth.
It is self-limiting and regression occurs in adulthood. Cosmetic surgery may be
employed after active growth has finished. Multilocular radiographic radiolucencies
occur at the angles of the mandible (1034HFig. 15.18) and the maxillary tuberosities.
Histologically the lesion is similar to the giant-cell granuloma.