Cystic Lesions of the Jaws in Children: A 15 Year Experience

Objectives: Review the clinical presentation, incidence, radiologic features, management, and outcomes of jaw cysts in children treated at a single tertiary care academic institution. Discuss the appropriate work-up and expected outcomes of children presenting with signs or symptoms suggestive of a jaw cyst. Methods: Retrospective case series of pediatric patients age 16 and under who presented with a cystic lesion of the jaw to a tertiary care academic medical center from 1997 to 2012. Charts were reviewed for presenting symptoms, signs, radiological findings, pathology, intervention, and outcomes. Results: The charts of 76 pediatric patients evaluated for a jaw mass were reviewed. Twenty-nine were diagnosed with a cystic jaw lesion. The most common cystic lesions were dentigerous cysts (45%) and odontogenic keratocysts (34%). Forty-one percent of all cystic lesions were asymptomatic at presentation. The most common presenting complaint was local swelling, followed by incidental findings on panorex and dental irregularities (tooth impaction, gum change, or lesion). All patients, excluding one with an eruption cyst, required surgical intervention. Odontogenic keratocysts tended to have the worst outcomes, with frequent recurrence and an average of 2.5 procedures required. Conclusions: Pediatric jaw cysts are unusual, and data are scarce regarding their presentation and management. Many are asymptomatic and identified by panorex imaging of the jaws. Dentigerous cysts were the most common lesion seen in our series, closely followed by odontogenic keratocysts. Surgical intervention is required in the majority of patients. Odontogenic keratocysts may require additional procedures for cure.