Conservative approach to unerupted teeth within cystic lesions in Gorlin's syndrome

The unerupted maxillary canine is the tooth that most commonly requires surgical exposure and guided eruption. The orthodontic specialist must be aware that delayed eruption is caused, sometimes, by serious pathologic conditions such as cystic or neoplastic malformation. A case of a 12-year-old girl who suffered from Gorlin's syndrome (nevoid basal cell carcinoma syndrome) is presented. Her symptoms were multiple jaw keratocysts, skeletal anomalies, and cleft lip and palate. Some authors advocate an aggressive surgical approach to jaw keratocysts because of their tendency to recur, thus sacrificing those teeth associated with them. Our view is that in young patients with Gorlin's syndrome, an attempt should be made to preserve permanent teeth, especially those vital for a normal growth pattern of the jaws. Therefore we recommend a conservative surgical approach, enabling guided eruption of unerupted teeth associated with cystic lesions in patients with Gorlin's syndrome.