Modern surgery, general and operative . y before the age of twenty. Follicular odontomes, or den-tigerous cysts [Yig. 152), oftenest spring from the follicles of the permanentmolars. In a dentigerous cyst there exists an expanded follicle which distendsthe bone, the follicle being iiUed with thick fluid and containing a portion of apermanent tooth. When a follicular odontome is discovered after the time ofsecond dentition the patient is short one or more permanent teeth. The corre-sponding milk teeth may be retamed. The position of the portion of the toothis variable. It is usually just beneat
Modern surgery, general and operative . y before the age of twenty. Follicular odontomes, or den-tigerous cysts [Yig. 152), oftenest spring from the follicles of the permanentmolars. In a dentigerous cyst there exists an expanded follicle which distendsthe bone, the follicle being iiUed with thick fluid and containing a portion of apermanent tooth. When a follicular odontome is discovered after the time ofsecond dentition the patient is short one or more permanent teeth. The corre-sponding milk teeth may be retamed. The position of the portion of the toothis variable. It is usually just beneath the orbit. In a case operated on in theJeflerson Clinic the tooth was in this situation. A fibrous odontome is due tothickening of the tooth-sac, which prevents eruption of the tooth; fibrous odon-tomes are usually multiple, and are apt to occur in rickety children. A cementomeis due to enlargement, thickening, and ossification of the capsule, the developingtooth being encased in cement. A compound follicular odontome is due to ossi-. fU Fig. 152.—Dentigerous cj-sts removed from upper jaw of a negro. Both in the right side. Con-tained portions of undeveloped teeth. fication of portions only of an enlarged and thickened capsule, and the tumorcontains bits of cementimi, portions of dentin, or small misshaped teeth. Aradicular odontome springs from the papilla and arises after the crown of thetooth is formed and while the roots are forming; hence it contains dentin andcement, but no enamel. Composite odontomes are formed of irregular, shapelessmasses of dentin, cement, and enamel. All the above forms occur m present themsehes as hard tumors associated with teeth or in an areawhere teeth have not erupted. Occasionally an odontome simulates necrosis;it is surrounded by pus, and a sinus forms. Treatment.—The diagnosis is now usuaUy possible b}- the aid of the . in no haste to excise large portions of bone for a doubtful growth; incisefirst and see if it be an
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