Decompression of a Mandibular Dentigerous Cyst Using a Dual-Purpose Removable Appliance in a Pediatric Patient: A...

Dentigerous cysts (DCs) are among the most common odontogenic lesions in mixed dentition. Management strategies vary from radical enucleation-often necessitating the removal of associated tooth germs-to more conservative decompression techniques. In pediatric patients, decompression is preferred as it preserves developing permanent teeth and supports normal eruption. In January 2023, an 8.5-year-old male presented to the Department of Pediatric Dentistry, Akdeniz University, with swelling in the right mandibular region. Clinical and radiographic examination revealed a unilocular radiolucent lesion associated with primary teeth #84 and #85. These teeth were extracted under local anesthesia, and the clinical, radiographic, and histopathological findings were considered most consistent with a DC showing secondary inflammation. During the same session, a removable acrylic appliance with drainage channels was fabricated from a conventional impression. The patient irrigated the lesion twice daily with saline while wearing the appliance. At 1 month, radiographs showed a reduction in lesion size. After 9 months, tooth #44 erupted into normal position, and the appliance was modified to function as a space maintainer until the eruption of the premolars. Decompression is frequently preferred for treating DC in children; however, silicone drains may reduce comfort and hygiene. In this case, a removable acrylic appliance provided decompression and was subsequently modified to function as a space maintainer. Such removable acrylic appliances may offer practical advantages in selected pediatric patients by facilitating hygiene, supporting eruption, and allowing subsequent space maintenance.