Hyperplastic dental follicle - review of literature and report of two cases in one family.

Hyperplastic dental follicle is an extremely rare lesion. The practitioner should be able to differentiate it from a dentigerous cyst. The present article will review related literature and report on two cases in one family. A 12-year-old white female and her 15-year-old brother were referred for exposure of unerupted canines. No systemic diseases or syndromes were present. Intra-oral examinations were unremarkable, except for the absence of all eight canines. Radiographic examinations revealed impacted canines with each unerupted tooth surrounded by a well-demarcated radiolucency, which passed beyond the cementoenamel junction. The teeth were surgically exposed and tissue specimens surrounding the unerupted teeth were analysed histologically. Histology revealed fibrous connective tissue with areas demonstrating some ground substance and multiple odontogenic epithelial rests. Some surfaces were partially lined by reduced enamel epithelium. A diagnosis of hyperplastic dental follicle was made. Sometimes, it is difficult to differentiate hyperplastic dental follicle from odontogenic fibroma, both simple and central forms. A correct diagnosis should be based on clinical, radiographic and histological findings.