Immense potential for self-healing with conservative management of a large radicular cyst associated with pulpectomized primary tooth: A 40-month follow-up.

Abstract

Radicular cysts are one of the most common cysts of inflammatory origin involving the maxillofacial region that arise from the remnants of Herwig's epithelial root sheath. These are often diagnosed as incidental findings on radiographs, which are seldom symptomatic and are slowly progressive. Decompression could be used as a conservative treatment approach for the management of large radicular cysts in children to have satisfactory healing and minimum damage to adjacent vital structures, simultaneously allowing the eruption of succedaneous tooth. This paper discusses the management of a large radicular cyst in a 12 year old, causing displacement of the mandibular canal and developing tooth germ using decompression that resulted in bony healing and spontaneous eruption of displaced succedaneous premolar, with a periodic follow-up for 40 months. Although decompression is a well-known approach, the present case with long-term follow-up emphasizes the potential of spontaneous healing in pediatric radicular cyst cases restoring the anatomy to normal without any functional impairment. This paper also highlights the importance of periodic clinical and radiographic follow-up in pulpally treated nonvital primary teeth.