Treatment of an impacted mandibular first molar with a dentigerous cyst and uprighting of a mesially tipped second molar

Impaction of thea mandibular first molar caused by a dentigerous cyst is a rare condition. ​​When confronting patients with complex cases, management of the cyst and orthodontic traction requires meticulous planning and staged treatment protocols to ensure optimal outcomes. This case report describes the successful multidisciplinary treatment of an 11-year-old male with a Class II skeletal relationship, an impacted mandibular right first molar associated with a dentigerous cyst, and a mesially tipped mandibular right second molar. The treatment approach included surgical exposure, cyst decompression, orthodontic traction, gingivectomy, and premolar extraction orthodontic treatment. Posttreatment outcomes demonstrated the preservation of mandibular molars, the establishment of a Class I molar relationship, and an improved facial profile.