Manejo clínico e cirúrgico de cisto dentígero em região posterior de mandíbula: relato de caso

Abstract

Introduction: A dentigerous cyst is one of the most common developmental odontogenic cysts of the oral cavity, usually associated with the crown of impacted or unerupted teeth. Although frequently asymptomatic, it can reach large dimensions and cause tooth displacement, root resorption, and, in rare cases, malignant transformation. The diagnosis is based on the correlation between clinical, radiographic, and histopathological findings, with treatment generally being surgical.

Case report: A 27-year-old male patient, without systemic alterations, was referred for dental evaluation. Radiographic examination revealed an impacted tooth 45 associated with an extensive unilocular radiolucent image involving its crown. Cone-beam computed tomography showed a well-defined lesion, approximately 20 mm in diameter, suggestive of a dentigerous cyst. Given the diagnostic hypothesis, surgical enucleation of the lesion was chosen, associated with extraction of the involved tooth, followed by histopathological analysis. The procedure was performed under local anesthesia, with osteotomy and complete removal of the lesion. The histopathological examination confirmed the diagnosis of dentigerous cyst. In the postoperative period, the patient presented adequate healing, without complications, and radiographic evidence of bone neoformation in the region. Additionally, orthodontic traction of the adjacent teeth was performed for functional rehabilitation.

Conclusion: Enucleation associated with extraction of the involved tooth proved to be effective for the treatment of dentigerous cyst, providing favorable clinical evolution and absence of recurrence during the initial follow-up. Accurate diagnosis and multidisciplinary planning are fundamental for the therapeutic success and rehabilitation of the patient