255 - Management of an Inflamed Dentigerous Cyst

Abstract:

Introduction: Dentigerous cysts are common odontogenic cysts associated with fluid accumulation in the dental follicle of unerupted or impacted teeth. Dentigerous cysts may manifest as delayed tooth eruption, adjacent tooth displacement, adjacent root resorption and bony expansion. Efficient management is important to prevent infection, bony fracture or disruption of neighboring anatomic structures. Surgical management via enucleation or marsupialization is often indicated to optimize clinical outcomes.




Case Report: This case report details the treatment of a 10-year-old male who presented to Children’s Wisconsin emergency department due to worsening right-sided facial swelling. The patient was previously healthy, with a history of full-mouth dental rehabilitation at CW in 2019, and was then lost to follow up. The patient was admitted with suspicion of facial cellulitis secondary to a dental abscess. Initial clinical examination suggested pulpal necrosis of pulpotomy treated teeth on the lower right contributing to the facial swelling. Initial radiographs showed additional pathology, indicating need for further imaging. A panoramic radiograph showed a cystic lesion in the lower right quadrant. The patient was then seen outpatient for extractions of involved primary teeth, followed by treatment under general anesthesia in coordination with oral surgery for cyst management. This report will discuss the clinical, radiographic, and histological findings, and treatment rendered for cyst management.

Identify Supporting Agency and Grant Number: Research supported by Children's Wisconsin.