Conservative Treatment Using Marsupialization for Cysts Occurring in the Jaw of Adolescents: A Case Report

Abstract

cc This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/ by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.Dentigerous cyst (DC) is an odontogenic cyst associated with the crown of an impacted, embedded, unerupted, or developing tooth. It is the second most common type of odontogenic cysts, accounting for 14% to 24% of all jaw cysts. Although these cysts occur more frequently during the second and third decades of life, they can also be found in children and adolescents in the mixed dentition stage. Treatment of the odontogenic cyst involves enucleation or marsupialization/decompression methods. The latter approach is preferred for larger cysts, and it is especially helpful in adolescent patients in conserving the unerupted permanent successors. The aim of treatment for DC is the complete elimination of pathology and maintenance of dentition with minimal surgical intervention. Recently defined criteria for the selection of treatment modality include the cyst size and location of the cyst, patient age, dentition involved, stage of root development, position of the tooth involved in the jaw, and relationship with the surrounding vital structure. Marsupialization or decompression technique has been advocated by several authors for treating DCs among young patients. In this conservative technique, the creation of an accessory cavity helps relieve intra-cystic pressure and accelerate the healing of cystic lesion. This technique has been successfully performed and is indicated for growing children and adolescents. Here, we report a large cyst lesion in the mandible treated by marsupialization for conservative management. In conclusion, successful reduction in size was achieved, and intraoperative complication could be prevented.

Decompression procedure as a successful initial approach to large maxillary dentigerous cyst in 12- year-old boy - a case report

“…Compared to other methods, it is significantly less technically demanding, less invasive, and has a lower incidence of postoperative complications 6,12 . It results in the shrinkage of the cyst volume, the preservation of the surrounding tissues, and the decreased rate of pathological fractures 9 .…”

“…Various treatment techniques have been described for the management of cystic lesions, including decompression, marsupialization, enucleation, bone resection, and their combination 5 . Established criteria for the election of the most suitable therapeutic approach are cystic lesion dimensions and localization, histological presentation, patient age, the position of the affected tooth, and its relation with the adjacent anatomical structures 6 .…”

Marsupialization as an Organ Preservation Measure in Management of Odontogenic Cyst

“…Different treatment approaches have been described; a treatment strategy is chosen according to the cyst size and the relationship between the cyst and the surrounding tissues and adjacent teeth 5 . It is possible to remove the cyst through enucleation (complete excision of the cyst) and wait for spontaneous bone regeneration to occur 6 .…”