Decompression of a Dentigerous Cyst Treatment in Mixed Dentition: A Case Report with 5 Years Follow-Up

Pub Date : 2023-09-20 DOI:10.1155/2023/8628326
Antoine Berberi, Georges Aad, Marise Nassar, Gwenaëlle Maalouf, Nabih Nader
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Abstract

Among developmental odontogenic cysts, the dentigerous type is the second most prevailing one. It is a benign intraosseous lesion commonly affecting the mandibular region. Dentigerous cysts present a high prevalence in children as they can be caused by the eruption of permanent teeth or the infection of deciduous ones. The adopted treatment modalities include enucleation (cystectomy), marsupialization, and decompression. Decompression maintains communication between the cyst and the oral medium through a sutured fixed device, namely an acrylic stent or a pretrimmed disposable suction tube. In the mixed dentition, the extraction of the affected primary teeth and the decompression approach is recommended, especially since children and parents are more tolerant of conservative treatments. We report in this study, a case of a 9-year-old boy complaining of a painful swelling in the left mandibular region. Intraoral and radiological examination revealed an expansion of the buccal and lingual cortical plates associated with teeth #73, #74, and #75 and a well-limited, unilocular radiolucent image extending from the distal aspect of tooth #31 to the mesial aspect of tooth #36 involving the crowns of the unerupted teeth #33, #34, and #35. The preliminary diagnosis was in favor of a dentigerous cyst. The treatment was to extract the deciduous teeth and to use a sterile tube for decompression. The patient was followed up for 5 years, a complete remission of the cyst was observed and the teeth #33, #34, and #35 re-erupted normally on the mandibular arch.
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混合牙列含牙囊肿减压治疗:1例5年随访
在发育性牙源性囊肿中,牙源性囊肿是第二常见的类型。它是一种良性骨内病变,通常影响下颌区域。牙囊肿在儿童中发病率很高,因为它们可能是由恒牙的爆发或乳牙的感染引起的。采用的治疗方式包括去核(膀胱切除术)、有袋化和减压。减压通过缝合的固定装置,即丙烯酸支架或预修剪的一次性吸引管,保持囊肿与口腔介质之间的沟通。在混合牙列中,建议拔除受影响的乳牙并减压入路,特别是由于儿童和家长对保守治疗更耐受。我们报告在这项研究中,一个9岁的男孩抱怨一个痛苦的肿胀在左下颌区域。口内和放射学检查显示与牙齿#73、#74和#75相关的颊和舌皮质板扩张,以及从牙齿#31的远端延伸到牙齿#36的近端,包括未爆发的牙齿#33、#34和#35的冠的有限的单眼放射透光图像。初步诊断为含牙囊肿。治疗方法为拔除乳牙,用无菌管减压。患者随访5年,囊肿完全缓解,下颌弓上#33、#34、#35牙重新正常出牙。
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