Management of a large dentigerous cyst

A dentigerous cyst surrounds the crown of an unerupted tooth. Although small dentigerous cysts can usually be treated by enucleation, a large cyst may cause extensive bone destruction and may lie close to vital structures.

Marsupialization creates a surgical opening between the cystic cavity and the oral cavity, thereby reducing intracystic pressure. Over time this can result in :

• Reduction in cyst size
• New bone formation
• Preservation of adjacent structures
• In younger patients, possible preservation and subsequent eruption of the associated permanent tooth

After sufficient reduction in size, secondary enucleation may be performed if necessary.