International Journal of Medical and Dental Case Reports (2017), Article ID 200917, 2 Pages

CASE REPORT

Incisive canal cyst - A case report

Tejavathi Nagaraj, Sita Gogula, C. K. Sumana, Haritma Nigam
Department of Oral Medicine and Radiology, Sri Rajiv Gandhi College of Dental Sciences and Hospital, Bengaluru, Karnataka, India

Correspondence: Abstract
Dr. Sita Gogula, Department of Oral Medicine The most common nonodontogenic cyst of the oral cavity which is developmental in,
and Radiology, Sri Rajiv Gandhi College of
origin, intraosseous and non-neoplastic in nature is nasopalatine cyst also called incisive
Dental Sciences and Hospital, Bengaluru,
canal cyst. The present case is about a 28-year-old male patient. Incisive canal cysts are
Karnataka, India. Email: sita.89513@gmail.com
normally diagnosed on routine radiological examination. They normally develop in the
Received 02 July 2017; midline of the anterior maxilla. Usually, these cysts are asymptomatic. This article reports
Accepted 13 September 2017 with the review of literature with respect to epidemiology, clinical features, radiographic
features, histopathology, treatment, and recurrence rates.
doi: 10.15713/ins.ijmdcr.71
Keywords: Incisive canal cyst, nasopalatine duct remnant, nonodontogenic in origin
How to cite this article:
Nagaraj T, Gogula S, Sumana CK, Nigam H.
Incisive canal cyst - A case report. Int J Med
Dent Case Rep 2017;4:1-2.

Introduction shown in Figure 3. As the cyst was asymptomatic patient was not
willing for further treatment.
In 1914 Meyer described the nasopalatine cyst for the first time.[1]
It is also termed as incisive canal cyst. They commonly develop
in the anterior maxillary region usually in the midline near the Discussion
incisive foramen. They usually develop from the remnants of
About 10% of the cyst of the jaw includes nasopalatine cysts. This
embryonic nasopalatine duct.[2,3] According to the WHO, it is
cyst has a broad age distribution and commonly diagnosed during
defined as developmental, epithelial, and nonodontogenic cysts
the 4-6th decade of life.[4,6,7] The etiology of the nasopalatine
of the maxilla along with nasolabial cysts.[3]
cyst is unknown. Women have more prevalence of these cysts
Normally, these cysts are asymptomatic, and if symptoms
in the ratio of 3:1 when compared to men.[8] Trauma, bacterial
are present, they are tolerable for a long time. Numbness is
infections are considered to be one of the etiological factors for
present when the cyst exerts pressure on the nasopalatine
nerves.[4] Clinically swelling is present posterior to the incisive
papilla.[5]

Case Report
A 28-year-old male patient reported to the department with
chief complaint of pain in the lower right back tooth region since
1 week. On clinical examination, there was deep dental caries
i.r.t to 46 with the tender on percussion. There was a swelling i.r.t
46 attached gingival with vestibular tenderness suggestive of the
periapical abscess with the establishment of sinus tract.
There was an Ellis class 3 fracture i.r.t 12 and Ellis class 2
fracture i.r.t to 11. Advised IOPAR i.r.t 46, 11, and 12. As shown
in Figure 1 and Figure 2 (profile view and intra oral picture).
Intraoral radiograph revealed a solitary well-defined
radiolucency in the midline i.r.t to 11 and 21 measuring about
2 cm × 1 cm approximately suggestive of incisive canal cyst as Figure 1: Profile view

1
Nagaraj, et al.
Figure 2: Clinical intraoral picture showing Ellis class 2
fracture of 21
Figure 3: Intraoral radiograph revealing a well-defined radiolucency
present between the roots of the incisors
initiation of this cyst.[9] Normally, these cysts are asymptomatic.
If symptoms are present, they are mild swelling and pain if it is
secondarily infected.
In this case, as the cyst was small in size it was asymptomatic,
and the patient preferred the restoration of the fractured tooth
i.r.t to 12 (Ellis Class II fracture).
Nasopalatine cysts are symptomatic when it attains a huge size
to exert pressure on the nasopalatine vessels causing numbness
and pain. Sometimes it causes elevation of the floor of the nose,
displaces the adjacent tooth and discharge is seen which may be
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Incisive canal cyst
serous or mucous. Pus discharge is seen when it is secondarily
infected.[10-12]
Histopathologically epithelium consists of stratified columnar
epithelium and simple cubic epithelium, stratified, squamous,
non-keratinized epithelium, false stratified columnar epithelium,
or any of the combination.[13]
Differential diagnosis: Incisive canal cyst may be misdiagnosed
as periapical cyst due to similar signs and symptoms when
the cyst is infected. Large incisive canal cysts are well defined,
round or oval or heart-shaped involving the roots of the incisors
radiographically but lamina dura is usually intact, and the pulp
is vital, whereas in radicular cyst pulp is nonvital and loss of
continuity of the lamina dura is present.[14]
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