Abstract

DEL VALLE, Sol C; CEDENO, José A; GARCIA-AROCHA, Raúl  and  GUERRERO, César. Tratamiento quirúrgico conservador del quiste dentígero en pacientes pediátricos atendidos en el postgrado de cirugía bucal facultad de odontología de la UCV: Seguimiento a largo plazo. Acta odontol. venez [online]. 2007, vol.45, n.3, pp.429-432. ISSN 0001-6365.

ABSTRACT According to most authors the common treatment for the dentigerous cyst has been total elimination of the cyst including the tooth involved; however if the lesion is present in young patients during the eruption period, and the radiographic and clinical features are suggesting of dentigerous cyst, an alternative treatment is the maintenance of the permanent tooth and enucleation of the lesion alone, stating that ameloblastomatous changes or other odontogenic lesions have been ruled out after histopathological analysis, and a diagnosis of dentigerous cyst is confirmed. This study was conducted on 12 patients with an age range of 6 to 16 years with a mean age of 9.4 years that were treated at the Oral Surgery Postgraduate Department, Dental School, Central University of Venezuela. There were 5 females and 7 males. All lesions were mandibular and all of them were unilocular and well-defined radiolucencies measuring less than 2,5 cms in greatest diameter. All cases involved the coronal portion with cervical attachment of an unerupted permanent tooth. Third molars were excluded. Patients underwent surgery (excisional biopsy) of the cyst with preservation of the involved tooth. Histologic diagnosis of dentigerous cyst was confirmed in each case. Clinical and radiographic follow-up was performed at 6 months intervals up to 7 years (1999-2006). There were no recurrences of radiolucent lesions in any of the post-surgical x-rays. Three (3) patients were followed for 7 years, four (4) patients for 5 years, two (2) patients for 3 years and 9 moths and three (3) patients for 2 years and 6 months. The cases showed new bone formation surrounding the teeth involved and complete eruption of the permanent dentition. Two (2) of the patients had to use orthodontic appliances to correct their malocclusion. Preservation of the tooth involved in a Dentigerous Cyst and the enucleation of the total lesion is an alternative surgical procedure with predictable and stable clinical and radiographic results. This treatment could be used as a conservative management for the dentigerous cyst allowing the normal eruption of the permanent dentition. This clinical study emphasizes the importance of an interdisciplinary team management (Oral Surgeons, Oral Pathologists and Orthodontists) and the continuous postoperative evaluation

Keywords : dentigerous cyst; surgical treatment; conservative surgical management; unerupted permanent tooth; odontogenic cyst; surgical pathology; eruption of permanent dentition.