Management of Dentigerous Cysts - A Review

BACKGROUND Lesions of a cystic nature have long been described in relation to the bones of the face. Over the course of the last four hundred years, such entities have been identified and studied in great detail; the evolution of systems of classification, the knowledge regarding the true nature of such phenomena, and the different ways of treating such maladies of the face have all undergone vast transformation since the 19th century. The introduction and development of anaesthetics, both general and regional, helped broaden the types of approaches to cysts of the orofacial region. Therapies of a conservative nature could be studied in greater detail with a larger population of patients, with the long term outcomes of such procedures yielding a significant amount of data, which in turn helped contrast such forms of management against more extensive and often radical procedures. Controversy has long surrounded the treatment of Dentigerous Cysts. Older techniques that had fallen out of favour amongst practicing surgeons returned decades later as serious contenders for becoming the treatment of choice for this particular pathology, the Partsch I technique being a prime example. The employment of the scientific method, conscientious effort towards ethics, and diligent recording of findings - whether prior to the surgical procedure or in the immediate and late post operative periods - all aided in the provision of a pool of knowledge that was made available to students and practitioners alike, providing clarity in the midst of opposing theories, guiding them in the selection of an appropriate treatment in response to cysts. Revolutions in medical imaging technology helped refine this process and will continue to serve the surgeon greatly in the pursuit of a treatment modality that is tailored to the needs of the patient and the demands of the lesion. Dentigerous cysts are anomalies that have been frequently encountered by practitioners, and the treatment for the same has long been discussed. The purpose of this paper was to review the existing evidence in relation to the management of Dentigerous Cysts, and to highlight in particular the efficacy of decompression amongst paediatric patients. We conducted a narrative review of literature using electronic databases such as Pubmed, Scopus, and Google Scholar involving studies with data on the modes of management of Dentigerous Cysts. The list of included studies was reviewed to find more significant articles for relevant evidence. KEY WORDS Dentigerous Cyst, Enucleation, Marsupialization