Decompression in the Management of Large Cystic Lesions Associated With Mixed Dentition Phase: 2 Case Reports

Large cystic lesions of the jaws in children present unique challenges due to potential damage to developing teeth and facial structures. Traditional aggressive treatments may compromise these structures. Decompression offers a minimally invasive alternative.

This report describes two pediatric female patients (ages 6 and 9) in the mixed dentition phase presenting with large, asymptomatic mandibular swellings. Diagnostic assessments including clinical examination, panoramic radiography, and histopathology revealed a large cystic lesion initially suspected as odontogenic in origin and later confirmed histopathologically as an ameloblastoma involving the impacted canine and premolar in Case 2. Both lesions caused significant bone destruction and tooth displacement.

Both patients underwent surgical decompression under general anesthesia. Case 1 involved decompression via extraction site, while Case 2 involved decompression followed by secondary surgery for definitive treatment after initial biopsy results. Follow-up over 15-42 months showed significant radiographic bone fill, shrinkage of the cystic cavities, and successful eruption in Case 1 and preservation of the involved teeth in Case 2 of the involved permanent teeth. No nerve damage or recurrence was noted during the follow-up period.

Within the limitations of this report, decompression appeared to be an effective and conservative management strategy for these large mandibular cystic lesions in the mixed dentition phase, allowing for bone regeneration and preservation of developing permanent teeth.