Interdisciplinary Management of an Infected Dentigerous Cyst Associated with an Impacted Maxillary Canine: A Case...

Dentigerous cysts are the second most common type of odontogenic cysts, typically associated with impacted teeth, particularly maxillary canines and mandibular third molars. They often remain asymptomatic until they reach a significant size, leading to complications, such as cortical bone expansion, root resorption, and potential infections. The management of dentigerous cysts in pediatric patients requires a multidisciplinary approach involving surgical, orthodontic, and prosthetic rehabilitation strategies. Advanced imaging techniques, such as cone-beam computed tomography (CBCT), are instrumental in accurately assessing the lesion's extent and guiding treatment. This case report highlights the diagnostic and therapeutic challenges associated with an impacted maxillary canine and a dilacerated lateral incisor, emphasizing the importance of timely intervention to prevent cystic progression and associated complications.

A 13-year-old boy presented with persistent pain in the upper right anterior region. His past dental history revealed the extraction of tooth #53 due to infection. Clinical and radiographic examination, including an orthopantomogram (OPG) and CBCT, confirmed the presence of an expansile radiolucent lesion associated with an impacted maxillary canine (tooth #13) and a dilacerated lateral incisor (tooth #12). However, noncompliance of the patient with further treatment at that time led to the recurrence of pain and increased severity of the lesion after 5 years. The lesion extended to adjacent structures, including the nasal cavity and maxillary sinus, with cortical bone perforation. A provisional diagnosis of a dentigerous cyst was established, with a differential diagnosis of an adenomatoid odontogenic tumor. In 2024, surgical management under LA involved enucleation of the cyst, extraction of teeth #12 and #13, and application of Carnoy's solution. Histopathology confirmed an infected dentigerous cyst. Following healing, a removable partial denture (RPD) was provided for esthetic rehabilitation. The patient was placed on periodic follow-up for a year.

This case highlights the importance of early diagnosis and intervention in pediatric patients presenting with impacted teeth and associated cystic lesions. The combination of advanced imaging, surgical enucleation, and adjuvant therapy proved effective in managing an extensive infected dentigerous cyst. The case further highlights the importance of a multidisciplinary approach to restoring both function and esthetics, ultimately improving patient outcomes in pediatric dentistry.

Early diagnosis and intervention are crucial in managing dentigerous cysts to prevent complications, such as bone destruction and infection. CBCT aids in precise assessment, while a multidisciplinary approach ensures optimal functional and esthetic outcomes. Long-term follow-up is essential to monitor recurrence and ensure successful rehabilitation.

Dutta K, Shetty YR, Nayak PP, et al. Interdisciplinary Management of an Infected Dentigerous Cyst Associated with an Impacted Maxillary Canine: A Case Report with a 6-year Follow-up. Int J Clin Pediatr Dent 2025;18(10):1288-1293.