Marsupialization: A conservative approach for treating dentigerous cyst in children in the mixed dentition

Abstract

Dentigerous cysts are usually encountered in the practice of pediatric dentistry. The treatment modalities range from marsupialization to enucleation of the lesion and are based on the involvement of the lesion with the adjacent structures. However, loss of a permanent tooth in the management of a dentigerous cyst can be devastating to a child who has already a congenitally missing tooth. The first case describes the technique of marsupialization in which we extracted the grossly carious deciduous 1st molar and created a window through the extracted socket to decompress the lesion. In this case the 2nd premolars were congenitally missing on both sides of the mandible for which we had not gone for enucleation of the dentigerous cyst along with the developing 1st premolar. The second case is a developmental type of a big dentigerous cyst where marsupialization was followed by enucleation of the cystic lining but without removal of the affected tooth. Both the teeth erupted in the oral cavity.

Conservative Treatment by Marsupialization of Dentigerous Cysts in Children: Report of three Cases

“…After marsupialization a stent, either a rubber tube or an obturator should be inserted into the cystic cavity opening to prevent spontaneous closure. This method has fewer complications than enucleation regarding the preservation of important anatomical structures and developing permanent tooth germs [2,3,6,9].…”

“…If untreated, these cysts may cause pathologic bone fracture, impaction of the permanent tooth, bone deformation, ameloblastoma and development of oral squamous cell carcinoma or mucoepidermoid carcinoma [3,7]. Due to the children have smaller jaws than adults, especially the bone fracture risk increases in children post-treatment, if the cyst was enucleated [13].…”

“…This therapy allow the eruption of the permanent tooth involved. Because incomplete root development maintain the eruptive force [2,3,8,9]. This case report presents three cases of dentigerous cysts which were associated with primary teeth caries in children.…”

“…It is characterized by a unilocular radiolucent lesion that encloses or displaced unerupted teeth [1]. There are fluid accumulation between the reduced enamel epithelium and the crown with expansion of the tooth follicle [2][3][4][5]. This often causes cortical bone expansion, displacement of adjacent and involved teeth, resorption of teeth roots, tooth mobility and sensitivity if it reaches a size larger than 2 cm in diameter.…”

Treatment of Radicular and Dentigerous Cysts With Marsupialization: A Retrospective Study

“…It is usually observed in the third molar tooth region in association with the impacted wisdom teeth (8). If dentigerous cysts are not treated, they may cause the pathological bone fractures, bone deformation, ameloblastoma, and the development of squamous cell carcinoma or mucoepidermoid carcinoma (9).…”