Eruption Cyst or Hematoma Clinical Features, Diagnosis and Treatment

Eruption cyst or Eruption Hematoma:

As the name suggests the Cysts is seen in Erupting Teeth in children below the Age of 10 and mostly associated with Permanent 1st Molars and then the Maxillary Incisors. It is mainly caused when the gingiva or Epithelium covering the tooth is thick. It is painful and can be clearly demarcated from the adjacent gingival tissue due to its black / bluish discoloration.

Definition:

Eruption Cyst or Hematoma is a Soft tissue analogue (a soft tissue version) of Dentigerous Cyst which develops as a result of separation of the dental follicle which is around the Crown of an Erupting Tooth which is inside the Soft tissue overlying the Alveolar Bone.

Clinical Features:

  •  It is a Soft Gingival Swelling, due to erupting tooth underneath
  • Translucent swelling in the Gingival mucosa overlying the crown of an Erupting Deciduous or Permanent tooth
  • Age: Children below the age of 10
  • Most common associated tooth is the 1st Permanent Molar and next are the Maxillary Incissors
  • Color: Blue to Purplish-Brown color
  • Cystic Fluid contains Blood hence the color Appearance which is mostly seen due to surface trauma caused by opposing tooth to the lesion
  • Painful and tender leads to pain on chewing food substances

Histopathologic Features:

  • Surface oral epithelium is made up of Nonkeratinizing Squamous Epithelium this forms the Roof of the Cyst
  • Beneath the Epithelium is the layer of Lamina Propria
  • Lamina Propria shows variable inflammatory cell infiltrate

Note: The points mentioned here are from roof of cysts excised to help in tooth eruption. It is not much important as C/F are mainly enough to identify the lesion

Treatment and Prognosis:

  • No immediate treatment is required if it is painless and within the Eruption time frame
  • Cysts Ruptures by itself to give way for he erupting tooth
  • If spontaneous rupture does not occur the Roof of the Cyst can be excised with a scalpel to help the Tooth to Erupt
  • Intervention is required if there is pain or tenderness while chewing and biting or the swelling turns red or yellowish which suggests inflammation or infection of the Cyst.

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