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TWO CASES OF DENTIGEROUS CYSTS TREATED BY MARSUPIALIZATION

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Abstract

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Dentigerous cyst is a cyst arising by a seperation of follicles from around the
anatomical crown of an unerupted tooth within the jaws. The dentigerous cyst is seen
during routine radiographic examination. It is detected radiographically as a sharply
delineated, round or oval, unilocular, homogeneous, and radiolucent area within which
there is the crown of an unerupted tooth. The histological appearance of the dentigerous
cyst is usually attached to the tooth at the cementoenamel junction and the sac lined by
a thin, regular, stratified squamous epithelium.
The dentigerous cyst can be treated by two surgical procedures : enucleation or
marsepialization. The size and location of the lesion usually dictates the surgical
procedures. The marsupialization consists of the removal of only a portion of the wall of
the cyst to make the remaining cystic lining continous with the oral mucosa. The cyst,
deprived of its supporting hydrostatic pressure, gradually shrinks until it is obliterated.
The marsupialization is the best way to conserve the tooth affected by a dentigerous
cyst and to permit its eruption, especially in a young person. Main advantages of the
marsupialization are its relative simplicity and its conservation with respect to adjacent
important structures.
In marsupialization technique, a plugger can be constructed, if necessary, to maintain
the opening and prevent food debris from entering the cystic cavity. However, the
disadvantage is the potentiality of leaving pathologic tissues. Therefore frequent recall
appointments are advisable.

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