Journal of the korean academy of Pediatric Dentistry (대한소아치과학회지)

Korean Academy of Pediatric Dentistry (대한소아치과학회)
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Surgical Management of Dentigerous Cyst for Preserving Permanent Tooth Buds

영구치 보존을 고려한 함치성 낭종의 외과적 처치

  • Park, Chanyoung (Department of Pediatric Dentistry, The Institute of Oral Health Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Park, Kitae (Department of Pediatric Dentistry, The Institute of Oral Health Science, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 박찬영 (성균관대학교 의과대학 삼성서울병원 치과진료부 소아치과) ;
  • 박기태 (성균관대학교 의과대학 삼성서울병원 치과진료부 소아치과)
  • Received : 2013.10.23
  • Accepted : 2013.12.11
  • Published : 2014.02.28
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Abstract

Dentigerous cyst is the most common developmental odontogenic cyst of the jaw which is associated with unerupted teeth. Treatment modalities range from enucleation to marsupialization. Enucleation is the process in which the cyst is completely removed, and this is usually indicated for smaller lesions. Larger cysts can be treated by marsupialization, which is a process that consists of making a surgical cavity on the wall of the cyst, emptying its content and maintaining the continuity between the cyst and the oral cavity. This procedure allows decompression of the cyst, regeneration of the bone-defected area, and also lets the wall of the cyst change into normal mucosa. This technique will protect adjacent structures and will promote spontaneous eruption of succedaneous teeth previously surrounded by the cyst. These are two case reports of a 5-year-old and an 11-year-old boy with dentigerous cysts found regarding supernumerary tooth and pulpotomized mandibular primary molars, respectively. Due to the large size of the cysts, both cases were treated with marsupialization. This case report shows that in cases regarding large-sized dentigerous cysts, marsupialization can be an effective surgical technique that promotes spontaneous eruption of cyst-involved succedaneous teeth and the preservation of adjacent teeth.

함치성 낭종은 미맹출치의 치관을 둘러싸는 퇴축법랑상피로부터 기원한다. 대부분의 함치성 낭은 적출술 또는 조대술로 치료된다. 조대술을 통해 낭 내부의 압력이 감소하고 골의 재생이 일어나면서 낭벽은 정상적인 점막으로 변하게 된다. 조대술은 적출술에 비해 인접 주요 구조물을 보호할 수 있다는 장점이 있다. 본 증례는 5세와 11세 남아의 상악 정중 과잉치와 치수 치료된 하악 유구치 부위에서 발견된 각각의 함치성 낭종을 치료한 증례로 모두 낭의 크기가 2개 이상의 인접 영구치의 변위를 발생시킬 정도로 크기가 매우 컸다. 환자의 나이가 어리고 낭의 크기가 커서 조대술을 이용하여 치료하였고 그 결과 변위된 인접 영구치의 맹출 방향이 개선되고 방사선투과상의 크기가 점점 감소하는 것으로 관찰되었다. 본 증례와 같이 크기가 매우 큰 함치성 낭의 경우에서 조대술을 이용하여 치료할 경우 위치가 변이된 인접치아를 보존하고 영구치의 자연 맹출을 유도할 수 있는 양호한 결과가 예상되기에 보고하는 바이다.

Keywords

References

  1. Sapp J, Eversole L, Wysocki G : Contemporary Oral and Maxillofacial Pathology. Daehan Publishing, 49-51, 2005.
  2. Neville B, Damm D, Allen C, Bouquot J : Oral & Maxillofacial Pathology. 2nd ed., Saunders, 590-592,2002.
  3. Kirtaniya BC, Sachdev V, Singla A, Sharma AK : Marsupialization: A conservative approach for treating dentigerous cyst in children in the mixed dentition. J Indian Soc Pedod Prev Dent, 28:203-208,2010. https://doi.org/10.4103/0970-4388.73795
  4. Delbem AC, Cunha RF, Afonso FL, Bianco KG, et al. : Dentigerous cysts in primary dentitions: Report of two cases. Pediatr Dent, 28:269-272, 2006.
  5. Bozdogan E, Cankaya B, Gencay K, Aktoren O : Conservative management of a large dentigerous cyst in a 6-year-old girl: a case report. J Dent Child,78:163-167, 2011.
  6. Benn A, Altini M : Dentigerous cysts of inflammatory origin. A clinicopathologic study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 81:203-209,1996. https://doi.org/10.1016/S1079-2104(96)80416-1
  7. Asia′n-Gonza′lez E, Pereira-Maestre M, Conde- Ferna′ndez D, Vilchez I, et al. : Dentigerous cyst associated with a formocresol pulpotomized deciduous molar. J Endod, 33:488-492, 2007. https://doi.org/10.1016/j.joen.2006.10.011
  8. The Korean Association of Oral and Maxillofacial Surgeons : Text of Oral and Maxillofacial Surgery. Medical and Dental Publishing Co, 395-396, 2005.
  9. Ziccardi VB, Eggleston TI, Schneider RE : Using fenestration technique to treat a large dentigerous cyst. J Am Dent Assoc, 128:201-205, 1997. https://doi.org/10.14219/jada.archive.1997.0165
  10. Scariot R, da Costa DJ, Rebellato NL, Muller PR, et al. : Treatment of a large dentigerous cyst in a child. J Dent Child, 78:111-114, 2011.
  11. Hupp JR, Ellis E, Tucker M : Contemporary Oral and Maxillofaical Surgery. 5th ed., Mosby Elsevier,455-456, 2008.
  12. Lustmann J, Bodner L : Dentigerous cysts associated with supernumerary teeth. Int J Oral Maxillofac Surg, 17:100-102, 1988. https://doi.org/10.1016/S0901-5027(88)80159-0
  13. Most DS, Roy EP : A large dentigerous cyst associated with a supernumerary tooth. J Oral Maxillofac Surg, 40:119-120, 1982. https://doi.org/10.1016/S0278-2391(82)80040-2
  14. McCrea S : Adjacent dentigerous cysts with the ectopic displacement of a third mandibular molar and supernumerary (fourth) molar: a rare occurrence. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 107:e15-20, 2009. https://doi.org/10.1016/j.tripleo.2009.02.002
  15. Lee IY, Kim TW, Kim YJ, Kim HJ et al. :Dentigerous cyst of a maxillary mesiodens: Case Reports. J Korean Acad Pediatr Dent, 35:548-555,2008.
  16. Shun Y : Dentigerous cyst associated with an impacted anterior maxillary supernumerary tooth. J Dent Child, 75:104-107, 2008.
  17. Ahn BJ, Chang CH, Lee DH : Dentigerous cysts in the child. J Korean Soc Plast Reconstru Surg,20:597-603, 1993.
  18. Serra e Silva FM, Sawazaki R, de Moraes M : Eruption of teeth associated with a dentigerous cyst by only marsupialization treatment: a case report. J Dent Child, 74:228-230, 2007.
  19. Jun EM, Kim TW, Kim HJ, et al. : A case report of a dentigerous cyst treated by marsupialization. J Korean Acad Pediatr Dent, 34:473-480, 2007.
  20. Song HJ, Kim JG, Yang YM, et al. : Spontaneous eruption of permanent teeth after marsupialization associated with dentigerous cysts. J Korean Acad Pediatr Dent, 38:194-201, 2011. https://doi.org/10.5933/JKAPD.2011.38.2.194
  21. Berti Sde A, Pompermayer AB, Couto Souza PH, Tanaka OM, et al. : Spontaneous eruption of a canine after marsupialization of an infected dentigerous cyst. Am J Orthod Dentofacial Orthop,137:690-693, 2010. https://doi.org/10.1016/j.ajodo.2009.10.023
  22. Kozelj V, Sotosek B : Inflammatory dentigerous cysts of children treated by tooth extraction and decompression-report of four cases. Br Dent J, 187:587-590, 1999.
  23. Torres-Lagares D, Segura-Egea JJ, Rodrl′guez- Caballero A, Llamas-Carreras JM, et al.. : Treatment of a large maxillary cyst with marsupialization, decompression, surgical endodontic therapy and enucleation. J Can Dent Assoc, 77:b87, 2011.
  24. Koca H, Esin A, Aycan K : Outcome of dentigerous cysts treated with marsupialization. J Clin Pediatr Dent, 34:165-168, 2009. https://doi.org/10.17796/jcpd.34.2.9041w23282627207

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  1. Minimally Invasive Marsupialization for Treating Odontogenic Cysts: Case Reports vol.44, pp.2, 2017, https://doi.org/10.5933/JKAPD.2017.44.2.235
  2. Retrospective Study of Characteristics and Treatment of Dentigerous Cysts Involving the Maxillary Anterior Tooth vol.44, pp.3, 2017, https://doi.org/10.5933/JKAPD.2017.44.3.280