Treatment of dentigerous cysts with a modified Hawley plate in children: report of two cases with radiographic results

Management of large inflammatory dentigerous cysts adapted to the general condition of the patient: Two case reports

Dentigerous cysts may be of developmental or inflammatory origin. The latter occur in unerupted permanent teeth as a result of inflammation from a preceding non-vital primary tooth or from another source spreading to involve the tooth follicle. This report presents two clinical cases of children with dentigerous cysts of inflammatory origin. Case 1 is a healthy boy (7 years 11 months) referred for a large cystic cavity in the right mandibular premolar region. Extraction of 84 and 85 and marsupialization of the cyst were performed under nitrous sedation. A removable appliance with an acrylic piece fitted into the socket was applied on the same occasion. The in-socket piece was progressively reduced as the cystic cavity was shrinking. After a 20-month follow-up, 44 and 45 are sound and correctly erupted and 46 remains unaffected. Case 2 is an autistic girl (10 years 9 months) with bilateral large odontogenic cysts enclosing the crowns of 35 and 45. Extractions of 75, 85 were performed under general anesthesia, leaving large bone defects. Given the limited compliance of the patient under common dental office circumstances, no appliance was used. Thirteen months after extraction, 35 and 45 are sound, fully erupted and no visible mesial drifting of 36 and 46 occurred. In conclusion, conservative treatment of large inflammatory dentigerous cysts in children gives good results with minimal intervention, ensures physiologic development of teeth and proper bone healing. The general condition of the patient can influence treatment choice. Patients must be followed up until eruption of the displaced permanent teeth and bony consolidation of the cyst.

Outcome of Mandibular Dentigerous Cysts 1 to 10 Years After Decompression Using a Custom-Made Appliance

PURPOSE

The aim of this study was to examine the long-term results of mandibular dentigerous cysts treated with decompression using a custom-made appliance.

PATIENTS AND METHODS

This retrospective study included 34 patients with dentigerous cysts who were treated as outpatients at the Faculty of Dentistry, Marmara University. Medical history, complaints, intraoral and extraoral clinical findings, treatment time, and complications of these patients were collected.

RESULTS

The average age of the patients was 7.94 years. Three tooth buds (canine, first permanent premolar [P1], and second permanent premolar) in 2 cases, two tooth buds in 7 cases (P1 and second permanent premolar in 6 cases and P1 and canine in 1 case), and one tooth bud in 25 cases were related to the cyst. The mean decompression time was 5.97 months (range, 3 to 9 months). No major complications occurred during or after decompression. No evidence of infection, breakdown and/or dehiscence of the soft tissue, or inferior alveolar nerve paresthesia was observed. The complications and complaints were minor and straightforward to resolve.

CONCLUSIONS

Decompression is a very effective and successful method for the treatment of mandibular dentigerous cysts.