Polypropylene Hub assisted Decompression of a Radicular Cyst in a Pediatric Patient: A Comprehensive Case Report

Radicular cysts are rare phenomenon in primary dentition which may result significant impact on the erupting permanent successors, bone destruction, leading to potential complications like bony fractures and spread of infection, if left untreated. Early diagnosis and minimally invasive management are crucial to preserve developing teeth and ensure favorable outcomes. In the present case report, a seven year old child reported with complaint of pain in the right upper front tooth region, clinically presented with a non-vital primary incisor (51) following a history of trauma one month back. Radiographic examination revealed diffuse periapical radiolucency with marked displacement of the permanent tooth bud 11 and 12 apically. CBCT demonstrated cortical plate perforation, nasal floor and palatal involvement, and erosion of the Nasopalatine canal, indicating aggressive lesion expansion. Fine-needle aspiration cytology and incisional biopsy were performed for definitive diagnosis. At the same time, a minimally invasive window decompression was carried out under local anesthesia, and the cystic cavity was kept patent using a chair side polypropylene needle hub. This approach facilitated gradual reduction in cyst size, prevented fluid accumulation, minimized infection risk, and promoted secondary bone formation, while preserving the permanent successor tooth and reviving its eruption potential.