Management of a large dentigerous cyst-

For a large dentigerous cyst, especially in young patients or where enucleation risks damaging vital adjacent structures (e.g., the developing tooth germs, inferior alveolar nerve, or maxillary sinus), marsupialization (decompression) is the treatment of choice. It involves creating a surgical window to allow the cyst to drain and gradually decompress, reducing its size over time; the residual, now-smaller lesion can subsequently be enucleated more safely if needed. Straightforward enucleation under GA is preferred for small cysts, not large ones with a risk of damaging surrounding structures.

Reference: Peterson's Principles of Oral and Maxillofacial Surgery, 3rd ed. – Management of Odontogenic Cysts.