Factors Influencing an Eruption of Teeth Associated with a Dentigerous Cyst. A Systematic Review

Abstract AimThis systematic review aimed to identify factors conducive/inconducive to a spontaneous eruption of teeth after a dentigerous cyst's marsupialization.MethodsIn accordance with the PRISMA guidelines, the main research question was defined in the PICO format (P: patients with dentigerous cysts, I: spontaneous eruption after surgery, C: forced eruption, O: determining factors potentially influencing the intervention or the comparison). The MEDLINE, the EMBASE, and the Cochrane Central Register of Controlled Trials databases were searched for the keywords combining dentigerous/odontogenic/follicular cyst with teeth and/or orthodontics, as well as human teeth and eruption pattern/interval/period/duration. The qualified articles (4 out of 3005 found initially) provided following data: a rate of tooth eruption after surgical treatment of the cyst, along with age and gender of patients, a perpendicular projection distance between the top of the tooth cusp and the edge of the alveolar process, tooth angulation, a root formation stage, the cyst size, and space to erupt. The articles underwent analysis of the risk of bias and quality, with the ROBINS-I protocol and the modified Newcastle-Ottawa QAS, respectively. The systematic review was registered in PROSPERO under ID CRD42020189044.ResultsA real risk of bias was assessed as critical, while the quality of the studies was considered high (7-9 points in 9-point scale). Small distance between the top of a tooth cusp and the edge of the alveolar process, and space for eruption larger than tooth dimensions were the factors likely to favor spontaneous eruption. The cyst size was irrelevant, while the influence of the other factors could not be determined from the available data. ConclusionA small number of published studies, as well as their heterogeneity and the critical risk of bias do not allow creating the evidence-based protocol of management the teeth with DC after its marsupialization. More high-quality research is needed to be able to draw more reliable conclusions.