Controversies Regarding the Management of Teeth Associated with Cystic Lesions of the Jaws

The continual growth of cystic lesions of the jaws can cause bone expansion, facial deformity, impacted teeth, occlusal disorder and displacement and loosening of the originating tooth or adjacent teeth. The management of teeth associated with cystic lesions of the jaws has been widely debated. When standing teeth with vital pulp are associated with cystic lesions, especially when tooth roots protrude into the cyst cavity, different treatment options have been recommended to support tooth preservation. However, there is no consensus about the extraction of the affected tooth in cases of root involvement by odontogenic keratocyst (OKC). In addition, there is controversy around whether root canal therapy should be considered a necessary treatment to be carried out prior to or after enucleation when standing teeth are associated with cystic lesions. An impacted tooth enclosed in the cavity of a developmental cyst may be treated by various approaches such as marsupialisation or decompression, or enucleation in combination with extraction or coronectomy, depending on the patient's age, root development and the angle and depth of the tooth in the jaw. Successful results obtained in pulp revascularisation after autotransplantation or endodontic regeneration treatments have been reported and pulp tissue functionality after cyst enucleation or apicetomy is a serious concern. In this article, we present an overview of the management of teeth associated with cystic lesions of the jaws.