Abstract
The purpose of this paper is to present a case of an impacted mandibular first molar associated with a dentigerous cyst and a missing mandibular second molar in an 11-year-old girl that was treated with combined surgical and orthodontic procedures. After clinical and radiographic evaluation, marsupialization of the cyst was decided, and a molar attachment was bonded on the buccal side of the impacted molar as a part of a full orthodontic treatment with fixed appliances. After 18 months of orthodontic traction, the molar was moved to a more advantageous position, and new bone apposition was observed on the site of the cystic lesion. Histological examination confirmed a dentigerous cyst. The molar was left to erupt spontaneously for 14 more months. A functional occlusion was finally achieved. An interdisciplinary approach proved to be an effective modality in treating a large dentigerous cyst associated with a deeply impacted first mandibular molar, presenting many advantages, such as new bone apposition and patient comfort.
Highlights
Tooth impaction can be defined as tooth retention due to an obstacle in the eruption path or—less commonly—due to an ectopic position of the tooth germ [1]
In cases of non-treatment, it can cause a decrease in the vertical dimension of the lower face, malocclusion, extrusion of the antagonist, root resorption in the adjacent teeth, or formation of a dentigerous cyst [4,5]
Dentigerous cysts are odontogenic cysts that originate by separation of the follicle from around the crown of an unerupted tooth [6]
Summary
Tooth impaction can be defined as tooth retention due to an obstacle in the eruption path or—less commonly—due to an ectopic position of the tooth germ [1]. Tooth impaction is relatively common (prevalence of 17%) [2], third molars being the most commonly affected teeth, followed by maxillary canines, mandibular premolars, and mandibular canines. The prevalence rate of impaction for the mandibular second molar ranges from 0.06 to 0.3%, and for the mandibular first molar, the prevalence described is
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