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capsule of the growing child, it was planned to treat the 8th week, IMF was released. As per our protocol, CT scans
lesion with simple enucleation procedure. (both axial and coronal view) and radiographs were taken
at regular intervals and evaluated. Radiographic follow‑up
Under general anesthesia, an intraoral incision was
placed along the anterior border of the ramus and the revealed sufficient bone filling with increased bone density
coronoid process and lateral surface of the mandible were from the margin to the center of the defect when compared
denuded [Figure 4]. The lesion was enucleated in total with the preoperative scans and radiographs [Figures 7‑10].
[Figures 5 and 6] along with the third molar. Extraction of
the impacted second molar was carried out, and Carnoy’s DISCUSSION
solution was applied along the entire bed of the lesion.
Inferior alveolar nerve was preserved by applying Vaseline Therapy for a cyst is determined by its etiology and
jelly [Figure 5]. Wire eyelets were placed on both sides localization, which, on the one hand, means that the
and watertight wound closure was achieved using layered causal tooth must be treated or removed and on the
suturing. Intermaxillary fixation (IMF) was done on the first other that the cystic lining, which secretes the cystic
[12]
postoperative day (for 8 weeks) to maintain intercondylar content, must be excised. This statement fits well with
distance. Her postoperative course was uneventful. the treatment characteristics of a dentigerous cyst.
Histopathologic examination revealed the presence Among various surgical treatment modalities to treat
of a cystic lining and connective tissue capsule. The a dentigerous cyst, enucleation of the cyst is the most
epithelial lining consisted of nonkeratinized 2‑4 layers of widely accepted procedure. Marsupialization is another
flattened epithelial cells. The epithelial and connective treatment modality, which is usually employed for large
tissue interface was flattened. The fibrous connective dentigerous cysts due to its significant size, possibility of
tissue wall was composed of dense collagen fibers and destruction of the surrounding tissue and concern for the
revealed islands of odontogenic epithelial rests, chronic potential of a pathologic fracture. [13]
inflammatory cells, chiefly plasma cells, and lymphocytes. Dentigerous cyst is more common in the third and fourth
All the features suggested a dentigerous cyst. decades and most of the surgical modality can be justified
[14]
Patient was discharged on the 10th postoperative day with
IMF and advised regular follow‑up (2 weeks interval). On

Figure 5: After enucleation inferior alveolar neurovascular bundle preserved

Figure 4: Intra oral exposure of cystic lesion

Figure 6: Enucleated specimen Figure 7: Three months post operative profile

296 Plast Aesthet Res || Vol 2 || Issue 5 || Sep 15, 2015