Decompression as a treatment modality for dentigerous cysts in children- Two case reports involving the maxillary arch with eighteen months follow-up

Dentigerous cysts are developmental odontogenic cysts that commonly arise around the crowns of unerupted or impacted teeth. In pediatric patients, early diagnosis and conservative treatment are vital to preserve the developing dentition and adjacent anatomical structures. This report describes two pediatric cases of large dentigerous cysts affecting the maxillary arch, managed successfully using a decompression technique. The first case involved a nine-year-old boy with a cyst associated with the unerupted right maxillary first premolar, and the second involved a six-year-old boy with a cyst associated with the unerupted left maxillary central incisor. Both lesions were detected incidentally during routine dental evaluations and confirmed radiographically using cone-beam computed tomography. Following cystic aspiration and extraction of the overlying primary teeth, customized acrylic decompression stents were fabricated and fitted after initial gauze packing to maintain patency and allow continuous drainage. The patients were followed monthly for 18 months. Progressive reduction in cyst size was observed clinically and radiographically, with spontaneous eruption of the involved permanent teeth, favourable bone regeneration, and preservation of adjacent structures and tooth vitality. These cases highlight decompression as a simple, minimally invasive, and effective treatment for large dentigerous cysts in children. It facilitates bone healing, supports eruption of developing teeth, and minimizes surgical morbidity. Early recognition and individualized conservative management can help preserve the developing dentition, reduce surgical trauma, and achieve excellent functional and esthetic outcomes in pediatric patients.