Dentigeruos cyst and dental dislocation: when the surgical technique can avoid orthodontic disinclusive treatment

Abstract

The dentigerous cyst (DC) is one of the most common cystic lesions that can be observed in the jaw and is associated with the crown of an included or impacted tooth. Radiographically it appears as a unilocular radiolucency surrounding the crown of an included or impacted tooth with a well-defined sclerotic edge. The pathogenesis of DC is controversial, in most cases it is of disembriogenetic origin, but it can also have inflammatory pathogenesis starting from a compromised deciduous element. The DC has development and asymptomatic course, for this reason it can reach considerable dimensions, involving adjacent noble structures, can lead to dislocation of contiguous dental elements or to deformation of the marginal bone profile. The therapeutic options are: surgical excision of the cyst or marsupialization. The objective of this study is to demonstrate how marsupialization is a conservative treatment for the dental element involved in the cystic lesion, able to promote its spontaneous eruption. The authors report 4 cases of large-sized dentigerous cysts, localized apically to infected deciduous elements, with dislocation of the immature permanent teeth involved. The cases were treated by extraction of the deciduous elements and marsupialization of the cystic cavity. After surgery, radiographic checks were performed through Orthopantomography. The clinical results obtained are supported by the literature indicating marsupialization as a conservative treatment in case of dentigerous cysts to favor the spontaneous eruption of the involved elements and the healing of the cystic lesion.