Document Type : Case Report
Dept. of Pediatric & Preventive Dentistry, MGM Dental College & Hospital, Navi Mumbai, Maharashtra, India.
Dept. of Oral & Maxillofacial Surgeon, MGM Dental College & Hospital, Navi Mumbai, Maharashtra, India.
Dept. of Pediatric & Preventive Dentistry, YMT Dental College & Hospital, Navi Mumbai, Maharashtra, India.
The treatment choice in the management of odontogenic cysts in the mixed dentition period depends upon the size, location of the cyst, the bone integrity of the cystic wall, and its proximity to vital structures. Enucleation is indicated with smaller cysts, achieved by careful removal of a complete cyst without rupturing the cystic lining. Marsupializationand decompression are the treatments of choice for larger cysts as it can help to preserve the tooth bud of the successor tooth and reduce morbidity. Marsupialization is achieved by opening and deroofing the cyst, and making the cystic lining continuous with the oral cavity or surrounding structures by suturing the edges of the incised mucosa to the cystic wall. This helps in maintaining the patency of the cystic lesion. In the decompression, a cylindrical device (drain) is placed in the lesion, which maintains communication between oral cavity to cystic lesion. This decreases the intracystic pressure and results in bone formation. We present two cases of odontogenic cyst in children, where we used a modified decompression technique. We developed a modified surgical stent with the use of a Hawley’s appliance, which led to cystic decompression, and eventual eruption of the successor tooth. Notably, this modified technique also reduced both patient discomfort and the number of clinical visits, making it an effective treatment option. The unique design of the appliance also acted as a space maintainer for the eruption of successor tooth, which is very critical in mixed dentition for future prevention of space loss and eventual malocclusion. The advantage of our design was its easy removal and insertion with minimal discomfort.
- Berti A, Pompermayer A, Souza P, Tanaka O, Westphanen V, Westphalen F. Spontaneous eruption of a canineafter marsupialization of an infected dentigerous cyst.Am J Orthod Dentofacial Orthop. 2010; 137: 690-693.
- Soliman MM, Hassan HA, Elgazaerly H, Sweedan TO. Marsupialization as a treatment modality of large Jawcysts. World ApplSci J. 2013; 21: 1752-1759.
- Kruger GO. Textbook of oral and maxillofacial surgery. 6th ed.Jaypee Brothers: New Delhi;1990.p.255-280.
- Tabrizi R, Hosseini*Kordkheili MR, Jafarian M, Aghdashi F. Decompression or marsupialization; which conservative treatment is associated with low recurrence rate in keratocysticodontogenictumors? a systematic review. J Dent (Shiraz). 2019; 20: 145-151.
- Norman G, Atkinson RA, Smith TA, Rowlands C, Rithalia AD, Crosbie EJ, et al. Intracavity lavage and wound irrigation for prevention of surgical site infection. Cochrane Database Syst Rev. 2017; 10: CD012234.
- Masuda K, Kawano S, Yamaza H, Sakamoto T, Kiyoshima T, Nakamura S, et al. Complete resolution of a calcifying cystic odontogenictumor with physiological eruption of a dislocated permanent tooth after marsupialization in a child with a mixed dentition: a case report. World J SurgOncol. 2015; 13:277.
- Laskin DM. Oral and maxillofacial surgery. 2th ed. The C.V. Mosby Company: St.Louis, Missouri, USA; 2006. p 427-487.
- Martínez-Pérez D, Varela-Morales M. Conservative treatment of dentigerous cysts in children: a report of 4 cases. J Oral Maxillofac Surg. 2001;59:331-333.
- Kirtaniya BC, Sachdev V, Singla A, Sharma AK. Marsupialization: a conservative approach for treating dentigerous cyst in children in mixed dentition. J Indian Soc Pedod Prev Dent. 2010; 28: 203-208.
- Sevekar S, Subhadra HN, Das V. Radicular cyst associated with primary molar: Surgical intervention and space management. Indian J Dent Res. 2018;29:836-839.
- Oliveros-Lopez L, Fernandez-Olavarria A, Torres-LagaresD, Serrera-Figallo M, Castillo-Oyagüe R, Segura-Egea J, et al. Reduction rate by decompression as a treatment of odontogenic cysts. Med Oral Patol Oral Cir Bucal. 2017; 22:e643-e650.
- De*Carvalho IK, Luna AH. Spontaneous Eruption of Premolar Associated with a Dentigerous Cyst. Case Rep Dent. 2016;2016:5323978.
- Nawaz MS, Yazdanie N, Faheemuddin M. Rehabilitation of a cystic mixed dentition mandible following marsupialization with a multipurpose acrylic splint acting as a space maintainer and an obturator. J Ayub Med Coll Abbottabad.2011; 23:177-179.
- Ziccardi VB, Eggleston TI, Schneider RE. Using fenestration technique to treat a large dentigerous cyst. JADA. 1997;128: 201-205.