Teeth preservation in dentigerous cysts: conservative approaches in pediatric patients

OBJECTIVES Dentigerous cysts are the most common developmental odonto-genic cysts. They are usually as-ymptomatic and related to the crown of an unerupted tooth. The standard treatment was cyst enu-cleation, but in the last years most of the authors opted to a more conservative approach: cyst marsupialization. The key point in the treatment of a dentigerous cyst is to preserve the tooth germ under the cyst and guide it to its normal position in the arch. MATERIALS AND METHODS In all the four cases was opted to marsupialize the cyst, preserve the tooth germ and send a part of the cystic wall to histological ex-amination. The marsupialization was effective in all cases. The ra-diological follow-up showed no recurrence and a good bone healing in all the patients. It was decided to place an orthodontic traction to guide the secondary tooth eruptive process in three cases. DISCUSSION AND RESULTS It is the opinion of the authors that cystic marsupialization is the best surgical option in children, because it has the same recur-rence rate as cyst enucleation and allows a definitive histologi-cal diagnosis reducing to the minimum the risk of damage to the dental germ.