Orthosurgical Treatment of Impacted Canines with the Presence of Bilateral Dentigerous Cysts: A Case Report with Five-Year Follow-Up.

Dentigerous cyst is a developmental odontogenic lesion associated with unerupted permanent tooth crowns and is rarely found in childhood. In general, the most used treatments are cystic enucleation and removal of the impacted tooth involved with the lesion. Aiming at the preservation of the affected teeth, marsupialization usually has been chosen. We report a rare case of bilateral dentigerous cysts associated with maxillary impacted canines treated by enucleation in association with orthodontic traction of a 11-year-old female patient. Initial clinical examination revealed Class II relationship and the absence of teeth 13 and 23. Radiographic examination revealed two mesially inclined impacted canines with the presence of a radiolucent halo surrounding their crowns, suggesting a diagnosis of dentigerous cyst. Surgical approach with cystic enucleation and bonding of the orthodontic device for traction were performed. Histopathological examination confirmed the diagnostic hypothesis. Surgical enucleation, tractions and orthodontic treatment allowed positioning the impacted canines in the dental arches, thus ensuring maintenance of support and esthetics of the periodontal tissues.