Dentigerous Cyst vs Unicystic Ameloblastoma — NDEB AFK MCQ
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Correct answer: D — The unicystic ameloblastoma shows ameloblastic differentiation of the epithelial lining (basal palisading with reverse nuclear polarisation) which is absent in a dentigerous cyst
Both dentigerous cysts and unicystic ameloblastomas can present as unilocular pericoronal radiolucencies. Histologically, the dentigerous cyst is lined by non-keratinised stratified squamous epithelium (2-4 cell layers) without ameloblastic features. The unicystic ameloblastoma shows ameloblastic differentiation: basal columnar cells with reverse nuclear polarisation and/or mural invasion. This distinction is critical because unicystic ameloblastoma has higher recurrence potential and may require more aggressive treatment than enucleation.
Reference: Neville – Oral and Maxillofacial Pathology, 4th ed., 2016