Decompression as a conservative treatment for dentigerous cysts in pediatric patients: a clinical case series and literature review

Background: Dentigerous cysts are benign odontogenic cysts generally associated with impacted or unerupted teeth. Although more commonly observed in adults, they can also occur in pediatric patients. Decompression offers a conservative treatment option for cyst management in children. This study aims to evaluate the clinical and radiographic outcomes of decompression therapy in pediatric patients with dentigerous cysts, through a case series and a literature review. Cases: In this study, four pediatric patients, aged 11 to 14 years, were diagnosed with dentigerous cysts following clinical, radiographic and histopathological evaluations. The following data was collected on each patient: age, gender, cyst location, symptoms, unerupted teeth on panoramic radiographs, and histopathological findings. Decompression therapy was initiated in all cases by placing surgical drains in the affected areas. Clinical examinations and radiographic imaging were performed regularly over a 12-month follow up to assess lesion resolution and associated tooth eruption. All cases demonstrated significant clinical and radiographic improvements. In this study, 3 patients had cystic lesions completely resolved without orthodontic treatment, along with impacted teeth emerging simultaneously within the cyst. In one case, despite the cystic cavity healing completely, the associated impacted tooth could not erupt due to completed root development. All teeth associated with cysts maintained their vitality in all cases. Neither serious postoperative complications nor recurrences of the lesions were observed. Conclusions: Decompression therapy is an effective and minimally invasive approach for managing dentigerous cysts in pediatric patients. By promoting lesion resolution and preserving adjacent structures, this technique facilitates bone healing and supports favorable outcomes in children with dentigerous cysts.