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Conservative treatment of dentigerous cysts in children: a report of 4 cases.

The standard treatment for a dentigerous cyst is enucleation and extraction of the involved tooth. In large cysts, an initial marsupialization to diminish the size of the osseous defect, followed by enucleation and tooth extraction, has been advocated.1-4 However, if the patient is a child and the cyst is small, as in the case of the enlarged follicles of impacted canines, surgical exposure of the tooth and orthodontic traction usually results in disappearance of the cyst and preservation of the tooth.5 When dealing with larger lesions, enucleation and tooth extraction have been favored. This can lead to functional, cosmetic, and psychologic consequences for the child. During the past 2 years, we have treated all the cystic lesions in the pediatric population using a very conservative approach. The following 4 case reports illustrate the success of this approach.