Aim: The aim of the article is to describe an unusual case of a non-syndromic patient affected by three follicular cysts in the mandible and then by an inflammatory cyst. Furthermore, we describe two different surgical approaches that we have used to manage this case: marsupialization and enucleation.
Background: Dentigerous cysts are usually solitary cyst, the presence of multiple cysts is often combined with systemic diseases such as mucopolysaccharidosis, cleidocranial dysplasia, and basal cell nevus syndrome. They are the second cysts in order of frequency. Because of the lack of symptoms, their diagnosis is frequently radiological, and it can be suspected by the failure of tooth eruption.
Case description: Two bilateral cysts of the third lower molars and radicular cyst of the right second lower molar were treated. An excisional therapy for the two dentigerous neoformations was performed. While, as a function of the remarkable dimensions which characterized the lesion, a conservative approach by marsupialization for 8 months before, and excision after, were chosen to solve the radicular inflammatory cyst. To preserve the patency of the cystic cavity, an acrylic obturator was used.
Conclusion: In t he c ase of multiple d entigerous c ysts, a deepen clinical and systematic examination should be done to rule out any associated syndrome. Nowadays in literature, there is not a single and significant orientation based on the results obtained from the various techniques, but this case report shows that it is possible to achieve the expected therapeutic success even if in the same patient.
Clinical significance: The case that we have described allows us to observe how a correct study of the lesions allows us to have a more accurate, safe and predictable therapeutic approach that lasts in time.
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