Appliance-Supported Decompression for Radicular Cysts Associated With Primary Molars: A Pediatric Case Series

Radicular cysts associated with primary teeth are uncommon in pediatric patients but may cause extensive bone destruction and displacement of developing permanent tooth germs. Conventional surgical enucleation may increase the risk of damage to adjacent structures; therefore, conservative treatment approaches such as marsupialization and decompression are preferred. Appliance-supported decompression systems have been increasingly used to maintain continuous drainage while preserving the eruption potential of permanent teeth.

This case series presents three pediatric patients aged 7-8 years diagnosed with radicular cysts, the most common type of radicular cyst, associated with primary mandibular molars. Following extraction of the affected primary teeth, conservative management was performed using decompression supported by fixed or removable appliances. Radiographic evaluation revealed large radiolucent lesions with varying degrees of displacement of permanent successors. Appliance design was individualized according to lesion characteristics and patient cooperation. Progressive reduction in cyst size, satisfactory bone regeneration, and spontaneous eruption or favorable repositioning of permanent teeth were observed during follow-up periods ranging from 3 to 20 months. No recurrence or major complications were detected.

Appliance-supported decompression is a minimally invasive and effective treatment option for inflammatory radicular cysts associated with primary teeth. This approach promotes bone regeneration, preserves permanent tooth eruption potential, and reduces the need for aggressive surgical interventions. Early diagnosis and regular follow-up are essential for achieving favorable clinical outcomes in pediatric patients.