Conservative management of extensive maxillary adenomatoid odontogenic tumor with a customized cyst plug: A case report emphasizing differential diagnosis and bone regeneration

Abstract Background This case report aims to present a misdiagnosed adenomatoid odontogenic tumor (AOT) initially suspected as a dentigerous cyst (DC), and to evaluate the effectiveness of a customized cyst plug in facilitating spontaneous bone regeneration without the need for bone grafting. Case presentation: We report a 13-year-old female with anterior maxillary swelling and a unilocular radiolucent lesion surrounding an impacted cuspid. Surgical decompression revealed abnormal tissue, confirmed as AOT histologically. Postoperatively, a palatal bone defect healed completely after 17 months of using a customized cyst plug, avoiding bone grafting. Conclusions This case highlights the diagnostic difficulty in distinguishing AOT from dentigerous cysts. In this single adolescent patient, a minimally invasive approach with a customized cyst plug was associated with radiographic bone fill of the postoperative defect. This graft-sparing strategy may be considered in selected cases; however, efficacy cannot be inferred from a single case, and longer-term comparative data are needed.