"Orthodontic extraction" for the treatment of dentigerous cysts

OBJECTIVES. Dentigerous cysts are a frequent finding in both jaws. They are usually treated by complete surgical enucleation with high risk of post-surgical complications, especially in case of large lesions. An innovative, more conservative and less traumatic approach is proposed in this paper. MATERIALS AND METHODS. 7 patients with mandibular cysts larger than 3 cm associated with impacted third molars were treated by a combined orthodontic-surgical approach. During cyst marsupialization under local anesthesia, tooth crown was exposed and an orthodontic bracket was bonded. RESULTS. The teeth were extruded and extracted with no post-surgical complications after that they were moved away from mandibular canal and new bone developed distally to second molar. A significant reduction of cystic cavity and improvement of periodontal health of adjacent second molars were obtained. CONCLUSIONS. This combined approach makes surgery easier and greatly reduces the risk of post-surgical complications. The procedure proved to be effective in treating large mandibular cysts associated with impacted third molars.