Large Dentigerous Cyst Complications — ORE Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

ModerateOral PathologyLarge Dentigerous Cyst ComplicationsORE Part 1

A patient has a well-defined unilocular radiolucency in the posterior mandible associated with an unerupted mandibular third molar. The radiolucency is attached at the cemento-enamel junction and surrounds the crown. It measures 4 cm at its greatest dimension. Which complication is most important to anticipate?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Pathological fracture from mandibular weakening

Explanation lettering: B = shown as A · A = shown as B · E = shown as C · C = shown as D · D = shown as E

A is correct. The CEJ-attached pericoronal radiolucency around an unerupted third molar is typical of a dentigerous cyst. In the posterior mandible, a large cyst can expand the jaw and thin both cortices, reducing structural strength. Pathological fracture is therefore an important risk before treatment and during surgical planning; decompression or staged management may be considered where bony support is substantially reduced. Osteosarcoma is not a recognised expected transformation of a dentigerous cyst. A sizeable established dentigerous cyst should not be expected to resolve spontaneously. Bilateral lesions may occur rarely but are not inevitable, and cardiovascular compromise has no relation to this local jaw lesion. UK FDS guidance recognises dentigerous cyst formation as relevant pathology associated with mandibular third molars.

Reference: Gendviliene I, et al. Conservative management of large mandibular dentigerous cysts with a novel approach for follow up: Two case reports. 2017. https://pubmed.ncbi.nlm.nih.gov/29243681/