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

Abstract

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.

The Temporary Mental Nerve Paresthesia as an Outcome of Dentigerous Cyst Removal during Preparation for Dental Implant Placement: A Case Report

“…The scope of many surgical procedures is still widely discussed. Each surgical approach can be related to various factors such as surgeon preferences, the age of the patient, the size of the bone defect that will heal on its own, will require GBR procedures, or can be treated with marsupialization, overall patient good cooperation, the biology of the cyst/tumor, and its histopathological result from a biopsy or other factors [25][26][27].…”

“…The discussion on possible oral supplementation for nerve rehabilitation is a topic of many studies. In nerve rehabilitation, a lot of attention is focused on vitamin B12, acetyl-L-carnitine (ALC), adenosine triphosphate/ATP, and others [27][28][29][30]. According to Hasegawa et al's study on refractory hypoesthesia, the authors highlight that early oral administration of ATP/vitamin B12 should be used in all cases of hypoesthesia.…”

“…Presented neurosensory deficits tend to improve in time, within 6 months or less. On the other hand, some authors advise some nerve stimulation, physiotherapy, or other agents [27][28][29]. Moreover, the type of nerve damage influences its healing and future outcome.…”

A case report and literature analysis of maxillary sinus odontogenic keratocyst invading the middle turbinate

“…The Dentigerous cyst of the maxilla usually protrudes into the maxillary sinus, and the cyst's edge tends to protrude with the sinus wall, presenting a smooth wall. The histopathological ndings indicate cyst uid and cyst wall without keratosis [13].…”

Dentigerous cyst: proposal for a therapeutic algorithm and combined treatment plan

“…Clinically, facial deformity accompanied by cortical expansion, slow growth, with obstruction from dental eruption, dental displacement, rarely presents root resorption and in extreme cases, pathological fractures can be caused by the magnitude about injury. Those are generally located in the jaw in 70 to 75% of cases 5,6 .…”