Conservative surgical-orthodontic treatment of a young patient with a dentigerous cyst
Tratamento cirúrgico conservador e ortodôntico em paciente jovem com cisto dentígero
De Carli, Marina Lara; Pedreira, Fernanda Rafaelly de O.; Guimarães, Eduardo Pereira; Dias, Nayara Nery de O.; Pereira, Alessandro Antonio Costa; Hanemann, João Adolfo Costa
Abstract
Introduction: The dentigerous cyst is a developmental odontogenic cyst, whose therapeutic approach depends on the size of the lesion. This paper describes the treatment performed on a 14-year-old male patient who presented with a large dentigerous cyst on the permanent mandibular left second molar. Case report: The permanent mandibular left first molar was extracted, and the lesion was decompressed and marsupialized by excision of the overlying mucosa, opening a window into the cystic cavity and suturing an acrylic resin drain to the oral mucosa. The specimen removed during surgery confirmed the diagnosis of a dentigerous cyst. Within ninety days of surgery, there was a significant reduction in lesion size. Orthodontic treatment was then started, and included traction of the impacted tooth and opening of adequate space with a fixed appliance, providing favorable tooth alignment and leveling. Conclusion: Marsupialization and orthodontic traction should be considered when planning the treatment of a dentigerous cyst, mainly in young patients with large lesions, to avoid damage to the surrounding structures.
Keywords
Resumo
Introdução: Cisto dentígero é um cisto odontogênico de desenvolvimento cuja abordagem terapêutica depende do tamanho da lesão. A proposta desse relato foi descrever o tratamento realizado em um paciente do gênero masculino de 14 anos de idade portador de cisto dentígero envolvendo o segundo molar permanente inferior esquerdo. Relato de caso: Foi realizada a exodontia do primeiro molar permanente inferior esquerdo e a lesão foi descomprimida e marsupializada através de um dreno de acrílico suturado na mucosa. O espécime retirado durante o ato cirúrgico confirmou o diagnóstico de cisto dentígero. Após 90 dias, houve diminuição significativa da lesão. Em seguida, iniciou‑se o tratamento ortodôntico, que incluiu o tracionamento do dente impactado e a abertura de um espaço adequado com um aparelho fixo, proporcionando alinhamento e nivelamento favoráveis. Conclusão: A marsupialização e o tracionamento ortodôntico devem ser considerados quando se planeja o tratamento de cisto dentígero, principalmente em pacientes jovens com lesões extensas, a fim de preservar estruturas nobres adjacentes à lesão.
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References
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