# Root Dilaceration and Dentigerous Cyst--A Cause-Effect Relationship?--\"Case-Series Study\"
## 4 Discussion  
Although DL and DCs have been reported in the literature, mainly as case reports, the cause-effect relationship between has scarcely been debated. Root DL is of great importance to orthodontics because dilacerated roots are harder to move orthodontically, have a higher risk of tooth impaction and root resorption, and impede the favorable insertion of miniscrews [58]. The cause of DL is still unknown, but many theories have been proposed, one of them being DC-associated with the dilacerated tooth or in closed contact with it. The purpose of the case series retrospective stud was to analyze if the DCs could be the single cause of root \begin{table}
\begin{tabular}{c c} \hline \hline
**Case** & **Summary of X-ray Findings** \\
**Number** & \\ \hline Case 4 & On the right side, the first and second mandibular molars (including the third molars) were **impacted** and associated with a sizeable DC, with the development of the roots delayed and the first molar being dilacerated. \\ Case 5 & On the left side, the situation was almost the same, with both the first and second molars being **impacted** and associated with DC. \\ Case 6 & The DC of the left second molar continued to grow, blocking the molar’s eruption and the development of its roots. \\ Case 7 & At that moment, both first mandibular molars were in the oral cavity, well aligned in the lower arch, but not in the appropriate one, because of the roots’ DL. \\ Case 8 & Impaction and root DL of the right/left first molar. \\ Case 9 & The DCs could be the cause of root DL because the tooth did not erupt, and the roots were constrained to develop in a closed area of dense bone. \\ Case 10 & Another factor that could determine the first molar’s root DL was the pressure applied by DCs of the second molar’s and likely the third molar’s buds. \\ \hline Case 5 & The upper right central incisor was **impacted** in a very high position, almost horizontally, with the root in the palatal bone. \\ Case 10 & DC-associated upper right central incisor. \\ Case 10 & **Congenitally missing** lateral incisor and a **supremumetary** tooth, partially below the central incisor. \\ Case 11 & Because of the **giganti** of the central incisor, the space for the missing right lateral incisor was closed, and there was not enough space for the canine, which remained **impacted**, included in a DC. \\ Case 12 & Root DL of all the incisors, being more evident on the left side. \\ Case 13 & For the left central incisor, the root DL could be explained by the closed contact of the DC-associated right central incisor, with its root at different vertical levels seen on the CBCT. \\ The right canine is **impacted**, included in a bigger DC than initially seen and with root DL. \\ \hline \hline \end{tabular}
\end{table} 
Table 1: _Cont._ \begin{table}
\begin{tabular}{c c c c c c c c c c} \hline \hline
**Case No./Position of** & **1 Right** & **1 Left** & **2** & **3 Right** & **3 Left** & **4 Right** & **4 Left** & **5 Right** & **5 Left** \\
**DLs or DCs** & **DL** & **DL** & **2** & **DC** & **DC** & **DC** & **DC** & **DL** & **DL** \\ \hline DL & Y & Y & Y & N & Y & Y & Y & Y \\ DC & Y & N & Y & Y & Y & Y & Y & Y \\ \hline \hline \end{tabular} Legend: “No.”: number, “DL”: root allocation; “DC”: deniferous cyst. “Y”: yes; “N”: no. 1 In case 5, although the DCs are situated in the right quadrant, the left central incisor is close to the DC of the right central incisor, therefore, in the table, a “Y” signals an association between the DL in the left quadrant and the DC in the right quadrant.  
\end{table} 
Table 2: Association between DCs and DLs. DLs. The patients included in this study were randomly selected, excluding patients with trauma or syndromic origin as etiology. Generally, both tooth DL and DCs are diagnosed unexpectedly at a routine X-ray exam. Therefore, a detailed 3D imaging investigation, CBCT, is mandatory to establish the appropriate treatment plan and reduce the severity of the case.