Management of extensive dentigerous cysts

Experience gained through a study of a case series of 40 large dentigerous cysts treated during an 11-year period from 1991 to 2002 is presented along with the clinical presentations and treatment modalities.Several modalities were indicated based on criteria such as patient age, cyst site, cyst size, involvement of vital structures by the cyst, and the strategic significance of the impacted tooth involved.In this series, cyst enucleation along with extraction of the impaction(s) was indicated in 34 patients. Cyst enucleation with preservation of the impacted tooth was indicated in six patients and these teeth erupted normally when root formation was incomplete. Orthodontics was used in cases requiring forced eruption or alignment.Decompression and cyst enucleation with tooth preservation are two treatment modalities indicated in growing children and adolescents.