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CONSERVATIVE MANAGEMENT OF A LARGE DENTIGEROUS CYST ASSOCIATED WITH
MULTIPLE ODONTOME: A CASE REPORT

Selvaraj L, KuppusamyR, Sukeri S, Raja ShahardinRZ, Sockalingam G
Introduction: Dentigerous cyst and odontome are two common odontogenic cyst and
tumour respectively. Odontome is a hamartoma which is composed of tissues native to the
teeth. Dentigerous cyst are seen in conjunction with odontome in 27.6% of cases. Case
report: A 16 -year-old boy was referred to our department because of a swelling and
mobile posterior teeth at the upper left quadrant. Examination revealed sulcus obliteration
and alveolar expansion associated with mobility of first and second upper left molars.
Radiographic examination showed a large unilocular radiolucent lesion with areas of
speckled calcification enclosing a displaced tooth 28 follicle. Aspirational biopsy yielded
clear straw-coloured fluid. A diagnosis of dentigerous cyst associated with odontome was
reached after incisional biopsy was performed under general anaesthesia. Management
also included marsupialisation and placement of stent, for the purpose of draining and
regular irrigation by the patient. After four months of close monitoring the swelling has
remarkably reduced in size. Enucleation and curettage of the pathological lesion was then
done, followed by placement of ribbon gauze impregnated with iodoform paste, which was
changed regularly. Subsequently, healing occurred with the residual cavity reduced in size.
Conclusion: The present case report highlighting that enucleation and marsupialisation are
successful treatment modalities for dentigerous cysts. Marsupialization and the placement
of stent was done to decrease the intracystic pressure, subsequently causing the shrinkage
of cyst therefore promoting bone fill. Finally, enucleation of the cyst including the dental
follicle and odontome was carried out to prevent possible recurrence.

Presented at the 5 MAPD Biennial Scientific Conference & Trade Exhibiton on 13 April 2019
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Dr Leezalini Selvaraj
Dr Radhadevi Kuppusamy
Dr Suriani Sukeri
Dr Raja Zarina Raja Shahardin
Dr Ganasalingam A/L Sockalingam
Department of Paediatric Dentistry
Tunku Azizah Hospital
Kuala Lumpur

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