Dentigerous cysts are developmental odontogenic cysts commonly associated with unerupted teeth, particularly in the mandible. This report presents a case of a large dentigerous cyst incidentally discovered in an 11-year-old patient during a routine orthodontic examination, involving an impacted second mandibular molar. A conservative approach using marsupialization was chosen to preserve adjacent anatomical structures and promote bone regeneration. Over a 15-month follow-up period, spontaneous eruption of the impacted molar was successfully achieved without complications to surrounding tissues and without the need for orthodontic traction. This case highlights the effectiveness of marsupialization in managing large mandibular cysts in pediatric patients, allowing natural tooth eruption and minimizing the necessity for invasive surgical procedures.
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