Modified Surgical Stent in Management of Odontogenic Cyst in Mixed Dentition: A Report of Two Cases

The treatment choice in the management of odontogenic cysts in the mixed dentition period depends upon the size, location of the cyst, the bone integrity of the cystic wall, and its proximity to vital structures. Enucleation is indicated with smaller cysts, achieved by careful removal of a complete cyst without rupturing the cystic lining. Marsupializationand decompression are the treatments of choice for larger cysts as it can help to preserve the tooth bud of the successor tooth and reduce morbidity. Marsupialization is achieved by opening and deroofing the cyst, and making the cystic lining continuous with the oral cavity or surrounding structures by suturing the edges of the incised mucosa to the cystic wall. This helps in maintaining the patency of the cystic lesion. In the decompression, a cylindrical device (drain) is placed in the lesion, which maintains communication between oral cavity to cystic lesion. This decreases the intracystic pressure and results in bone formation. We present two cases of odontogenic cyst in children, where we used a modified decompression technique. We developed a modified surgical stent with the use of a Hawley’s appliance, which led to cystic decompression, and eventual eruption of the successor tooth. Notably, this modified technique also reduced both patient discomfort and the number of clinical visits, making it an effective treatment option. The unique design of the appliance also acted as a space maintainer for the eruption of successor tooth, which is very critical in mixed dentition for future prevention of space loss and eventual malocclusion. The advantage of our design was its easy removal and insertion with minimal discomfort.