Interdisciplinary management of dentigerous cyst in a pediatric patient

Abstract

Introduction. Dentigerous cysts are the most common odontogenic lesion. In Mexico, their prevalence is up to 36%. The etiology is the persistence of epithelial remnants derived from the tooth formation process. There are different surgical techniques for cyst management: enucleation, marsupialization, and decompression of the lesion, the latter aiming to preserve the permanent tooth. Management depends on factors such as the patient's age, position, angulation, and the space available for the eruption of the permanent tooth. Case report. A 9-year-old male patient attended the pediatric dentistry clinic at ENES León with the complaint: "He developed a lump that won't go away." Clinical examination revealed an asymptomatic increase in volume, with a hard consistency that softens toward the distal area of the lesion. Diagnostic aids, including radiographs and a computed tomography scan, were requested, which revealed a 2 × 1.5 cm lesion extending from the distal region of tooth 74 to the mesial region of tooth 36, with involvement of teeth 75 and 35. The clinical approach consisted of assessment of the vitality of tooth 36 by the Endodontics Department, surgical enucleation of the lesion along with the involved teeth by the surgical department, histopathological study by the Maxillofacial Pathology Department, and interceptive orthodontic management by the Pediatric Dentistry Department. Conclusion A dentigerous cyst is a benign entity that can cause deformities, tooth displacement, and compromise adjacent structures. Its interdisciplinary approach allows for comprehensive diagnosis and treatment.