Treatment of a Dentigerous Cyst with Transposition of the Permanent Tooth Germ: A Case Report

Abstract

Background: General factors such as endocrine disorders, osteopetrosis, Gorlin syndrome, and cleidocranial dysplasia or local factors such as supernumerary teeth, odontoma, cysts, tumors, dense mucoperiosteum, ankylosis, abnormal inclination and crowding, malposition of the tooth germ, dilacerations and trauma are the main causes of impacted teeth. In the case of a traumatic primary dentition, even a permanent tooth germ could be damaged. As shown in clinical results, malposition and disturbances of eruption, root deformation, and eruption disturbances could occur. According to dental literature generally accepted treatment options are surgical repositioning, extraction, and orthodontic traction. Case description: A 10-year-old girl was referred by a pediatric dentist to the Health Science University of Istanbul with a pain complaint in the right lower quadrant. After a radiological examination, a cystic formation around the malposed permanent tooth germ and deep dentin caries in primary and permanent teeth in the lower right region were found. Surgical intrafollicular transposition was performed in order to correct the position of tooth 44’s germ and a full eruption to the correct position and root development were observed during the follow-up by the end of the first year. Conclusion: Both early diagnosis and treatment are critically important for the prognosis of dislocated permanent tooth germ. Orthodontic traction could also be considered as a treatment option in hard cases instead of referring directly to extraction. Surgical repositioning of impacted permanent tooth germ could prevent malposition at later ages. Spontaneous eruption and function at occlusion are expected after surgical intervention.

Keywords

• permanent tooth germ
• surgery
• transposition