Conservative Management of Dentigerous Cysts in Mixed Dentition: a Case Series

Öz

Dentigerous cysts are among the most common odontogenic cystic lesions observed in children. They are typically asymptomatic and often discovered incidentally during routine radiographic examinations. While conventional treatments generally involve enucleation of the cyst and extraction of the associated tooth, conservative approaches such as decompression are increasingly recommended in pediatric patients to preserve permanent teeth and maintain normal jaw development. This case series presents three pediatric patients treated for dentigerous cysts at our clinic using decompression tube placement. In all cases, the cystic lesions were associated with unerupted permanent tooth crowns. The overlying primary teeth, nearing natural exfoliation, were extracted to gain access to the cystic cavity and allow decompression tube placement. Radiographic follow-up at six months revealed complete cyst resolution and bone regeneration in all cases, after which the decompression tubes were removed. No enucleation was performed. The decompression technique is an effective and minimally invasive method for managing dentigerous cysts in pediatric patients, particularly for preserving developing permanent teeth. The cases presented support the successful outcomes of this conservative treatment approach.

Anahtar Kelimeler

• Dentigerous cyst
• decompression
• conservative treatment
• mixed dentition

Karışık Dişlenme Döneminde Dentigeröz Kistlerin Konservatif Tedavisi: Bir Vaka Serisi

Öz

Dentigeröz kistler, çocuklarda en sık rastlanan odontojenik kistler arasındadır. Genellikle asemptomatiktirler ve çoğunlukla rutin radyografik incelemeler sırasında tesadüfen keşfedilirler. Geleneksel tedaviler genellikle kistin enükleasyonu ve ilişkili dişin çekimini içerirken, pediatrik hastalarda daimi dişlerin korunması ve normal çene gelişiminin sağlanması amacıyla dekompresyon gibi konservatif yöntemler giderek daha fazla önerilmektedir. Bu vaka serisi, kliniğimizde dekompresyon tüpü yerleştirilerek tedavi edilen üç pediatrik hastayı sunmaktadır. Tüm olgularda, kistler gömülü daimi diş kronları ile ilişkiliydi. Sürme yolunda bulunan doğal düşme zamanı gelmiş süt dişleri çekilerek kist kavitesine erişim sağlandı ve dekompresyon tüpü yerleştirildi. Altı aylık radyografik takipte, tüm vakalarda kistin tamamen iyileştiği ve kemik rejenerasyonu izlendi; bu süreç sonunda dekompresyon tüpleri çıkarıldı. Vakalarda enükleasyon uygulanmadı. Dekompresyon tekniği, özellikle gelişmekte olan daimi dişlerin korunması açısından pediatrik hastalarda dentigeröz kistlerin yönetiminde etkili ve minimal invaziv bir yöntemdir. Sunulan vakalar, bu konservatif tedavi yaklaşımının başarılı sonuçlarını desteklemektedir.

Anahtar Kelimeler

• Dentigeröz kist
• dekompresyon
• konservatif tedavi
• karışık dişlenme dönemi

Kaynakça

1. 1. Cigerim L, Kaplan V, Guzel M, et al. Decompression method of treatment for dentigerous cyst associated with impacted lower second molar tooth. Van Dis Hekim Derg. 2021; 2: 48-51.
2. 2. Sardana D, Goyal A, Gauba K. Management of an inflamed dentigerous cyst in a patient with an anterior cross-bite, using a modified obturator: case report. S Afr Dent J. 2016; 71: 266-9.
3. 3. Al Tuwirqi A, Khzam N. What do we know about dentigerous cysts in children: a review of literature. J Res Med Dent Sci. 2017; 5: 67-79.
4. 4. Shetty RM, Dixit U. Dentigerous cyst of inflammatory origin. Int J Clin Pediatr Dent. 2010; 3: 195-8.
5. 5. Couto PRC, de Lima Moura RJ, de Melo Freitas T, Saboia RDSC. Treatment modalities of dentigerous cysts: literature review. Clin Lab Res Dent. 2022; 3: 100047.
6. 6. Cobo-Vázquez C, Fernández-Gutiérrez L, Pérez Fernández B, et al. Effectiveness of conservative treatment of dentigerous cyst in the pediatric patient: a systematic review. J Stomatol Oral Maxillofac Surg. 2024; 125: 102115.
7. 7. Aldelaimi AA, Enezei HH, Berum HER, et al. Management of a dentigerous cyst; a ten-year clinicopathological study. BMC Oral Health. 2024; 24: 831.
8. 8. Hyomoto M, Kawakami M, Inoue M, Clinical conditions for eruption of maxillary canines and mandibular premolars associated with dentigerous cysts. Am J Orthod Dentofacial Orthop. 2003; 124: 515-20.

9. 9. Chouchene F, Ameur WB, Hamdi H, et al. sConservative approach of a dentigerous cyst. Case Rep Dent. 2021; 2021: 5514923.
10. 10. Allon DM, Allon I, Anavi Y, et al. Decompression as a treatment of odontogenic cystic lesions in children. J Oral Maxillofac Surg. 2015; 73: 649-54.
11. 11. Nahajowski M, Hnitecka S, Antoszewska-Smith J, et al. Factors influencing an eruption of teeth associated with a dentigerous cyst: a systematic review and meta-analysis. BMC Oral Health. 2021; 21: 11.
12. 12. Ozkan E, Ozmen B. The treatment of different odontogenic cysts in children only using acrylic appliance-guided decompression: a long-term clinical study. Anatol Clin J Med Sci. 2023; 28: 15-23.
13. 13. Khalifa C, Garma M, Mabrouk R, et al. Conservative management of dentigerous cyst in children: report of two clinical cases. Clin Case Rep. 2023; 11: E7051.