Journal of Oral Implantology April 2014 - (Page 189)
CASE REPORT
Nasopalatine Duct Cyst, a Delayed Complication to
Successful Dental Implant Placement: Diagnosis and
Surgical Management
Shane Joseph McCrea, MMedSci, MSc
The dental literature reports frequently on both the success and survival of dental implants, whereby the focus
remains on the biological response of hard and soft tissue to the implants. The predication and anticipation of
adverse implant events can then lead to the preemption of implant loss. However, biological situations can arise
that are outside the control of the clinician. The author reports a case history of the late manifestation of a
nasopalatine duct cyst in close proximity to a dental implant and its subsequent surgical management.
Key Words: implantology, nasopalatine duct cyst, symphyseal graft
INTRODUCTION
T
he use of dental implants for oral
rehabilitation is now an accepted form
of treatment. The dental literature reports frequently on both the success and
survival of dental implants, whereby the
focus remains on the biological response of hard
and soft tissue to the implants: peri-implantitis,
periapical implantitis, marginal bone level maintenance,1 increased pocket-probing depths, mucositis, suppuration, and attachment loss.2 The predication and anticipation of adverse implant events
can then lead to the preemption of those events.
However, biological situations can arise that are
outside the control of the clinician. The author
reports a case history of the late manifestation of a
nasopalatine duct cyst (NPDC) in close proximity to
a dental implant and its subsequent surgical
management.
The World Health Organization classifies the
NPDC as a developmental, epithelial, nonodontogenic cystic lesion of the maxilla. The nasopalatine
duct cyst is the most common nonodontogenic cyst
of the oral cavity,3 occurring in about 1% of the
British Society of Oral Implantology Southport, Merseyside, UK.
* Corresponding author, e-mail: shanemccrea@aol.com
DOI: 10.1563/AAID-JOI-D-12-00011
population.4 Radiographically, it can be mistaken for
an apical lesion of endodontic origin. The cyst is
believed to arise from the epithelial remnants of the
nasopalatine duct, an embryological structure
connecting the oral and nasal cavities in the area
of the incisive canal.5 The cyst is unique, occurring
in a single location, the midline of the anterior
maxilla, developing at almost any age. However, the
most common occurrence is in the fourth and sixth
decades,4 with most studies showing a slight male
predominance.6 The cysts are usually asymptomatic,
being an incidental radiographic discovery. The
most common reported clinical symptom is swelling of the anterior part of the palate in the vicinity
of the incisal papilla and sometimes intermittent
pain over a long period of time.7 If the cyst has
caused resorption of the overlying bone, it is
fluctuant and appears blue.8 Mucoid discharge
may occur, causing patients to complain of a salty
or foul taste. The more advanced cases can cause
pain and itching.7,8
Radiographic findings
Two-dimensional radiographs usually demonstrate
a well-circumscribed round or oval radiolucency
with a sclerotic border at or near the midline of the
anterior maxilla, between and apical to the central
Journal of Oral Implantology
189
Table of Contents for the Digital Edition of Journal of Oral Implantology April 2014
Consolidated Standards of Reporting Trials (CONSORT): Answering the Call for JOI’s Endorsement
Photoelastic Analysis of Stress Distribution With Different Implant Systems
Influence of Abutment Screw Design and Surface Coating on the Bending Flexural Strength of the Implant Set
Comparison of Implant-Abutment Interface Misfits After Casting and Soldering Procedures
Evaluation of Accuracy of Casts of Multiple Internal Connection Implant Prosthesis Obtained From Different Impression Materials and Techniques: An In Vitro Study
The Effect of Different Implant-Abutment Connections on Screw Joint Stability
Effects of pH and Elevated Glucose Levels on the Electrochemical Behavior of Dental Implants
Finite Element Analysis of Provisional Structures of Implant-Supported Complete Prostheses
Saliva Versus Peri-implant Inflammation: Quantification of IL-1b in Partially and Totally Edentulous Patients
Heat Generated During Seating of Dental Implant Fixtures
An Alternative Approach for Augmenting the Anterior Maxilla Using Autogenous Free Gingival Bone Graft for Implant Retained Prosthesis
Nasopalatine Duct Cyst, a Delayed Complication to Successful Dental Implant Placement: Diagnosis and Surgical Management
The Custom Endosteal Implant: Histology and Case Report of a Retrieved Maxillary Custom Osseous-Integrated Implant Nine Years in Service
Occlusal Concepts Application in Resolving Implant Prosthetic Failure: Case Report
Three-Year Follow-Up of a Single Immediate Implant Placed in an Infected Area: A New Approach for Harvesting Autogenous Symphysis Graft
Use of Stress Analysis Methods to Evaluate the Biomechanics of Oral Rehabilitation With Implants
Journal of Oral Implantology April 2014
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