High-density areas within low-density areas in radiographs of dentigerous cysts

Purpose: This study aimed to analyze radiographs of dentigerous cysts containing high-density areas within lowdensity areas to identify their characteristic radiographic features.Materials and Methods: This retrospective study included histopathologically confirmed cases of dentigerous cysts in patients who underwent computed tomography (CT).The analyses included demographic data, the position of the lowdensity area relative to the impacted tooth, and the number, size, and location of the high-density area within the lowdensity region.Group comparisons were performed for each analytical factor.Results: The patients were classified into 550 cases of dentigerous cysts without high-density areas and 34 cases with high-density areas within the low-density regions.In the group with high-density areas, the low-density regions more frequently extended beyond the cementoenamel junction toward the center of the tooth root.In addition, many lesions exhibited high-density areas with a maximum diameter of less than 3 mm, contact with the tooth crown, and involvement of impacted teeth. Conclusion:Lesions displaying high-density features, such as a maximum diameter <3 mm, contact with the tooth crown, and association with impacted teeth, are likely dentigerous cysts.These findings suggest that dentigerous cysts containing high-density areas differ from other lesions with calcified components.Although such cases are rare, recognizing them is important for understanding the disease spectrum.(Imaging Sci Dent 20250156)