Conservative Management of a Radicular Cyst, associated with a Pulpectomised Primary Molar Followed by Bonded Space Regainer for Eruption of Premolar: A Case Report

Background: Pulpectomy is considered as a conservative treatment option for pulpally involved primary teeth. Although it is safe, there are certain undesirable consequences, one of which being odontogenic cysts. Peri-radicular cysts associated with endodontically treated primary molars show specific clinical features such as large size, rapid growth, buccal expansion, and displacement of succedaneous teeth.

Treatment options for a radicular cyst involving primary teeth include extraction of the involved primary tooth or extraction and then decompression of the cyst,marsupialization or enucleation of the lesion.

Case Description: A radicular cyst associated with a pulpectomised mandibular primary molar in a 10-year-old male patient is described here along with the radiographic and histopathological findings. The cyst was treated by extraction of the involved primary tooth followed by marsupialization for decompression. This case is still under follow up and the outcome 1 year after decompression is presented here. The eruption of blocked out succedaneous tooth was facilitated by placing a bonded space regainer using Nickel- titanium (NiTi) wire. 3 mm of the lost space was regained within 8 weeks using the bonded space regainer.

Conclusion: Extraction of the involved primary teeth followed by decompression of the cyst and preservation of the permanent teeth appeared to be the most suitable treatment option for large lesions in a developing dentition.

Clinical Significance: Non-invasive treatment option should be considered for the management of radicular cysts in pediatric patients. Bonded space regainer is an efficient treatment modality for regaining lost space.