Traditional management of odontogenic cysts, such as enucleation or resection, can lead to complications, particularly in larger cysts or those near vital structures. Surgical decompression offers a more conservative approach, reducing the size of the cyst gradually by creating a small opening in the cyst wall. This method aims to minimize the risk of complications while preserving surrounding tissues. Despite its advantages, there is a need for more evidence on the long-term outcomes of decompression.
Objective: The aim of the present study was to assess the extent
of cyst size reduction, healing time, and potential recurrence rates in nine
newly treated cases, providing further evidence on the viability and
limitations of decompression as an alternative to more invasive surgical
approaches for managing odontogenic cysts.
Materials and Methods: This prospective study focused on 9
patients diagnosed with cystic lesions and treated between January 2015 and
June 2019. Patients involved in this study had a point in common which was the
presence of a radiolucent image in the mandibular or the maxilla bone with
well-defined margins. Some of them enclosed the crown of an impacted permanent
tooth. These images were suggestive of the diagnosis of dentigerous cyst,
keratocyst or even inflammatory cyst. The treatment consisted of
marsupialization or decompression requiring or not a second surgical time.
Patients attended follow-up visits at regular intervals (every week for one
month then every month) to monitor cyst size and ensure proper stent function.
The study protocol adhered to ethical standards, with informed consent obtained
from all participants, ensuring confidentiality and adherence to safety
protocols.
Results: Nine healthy patients were included in the study. The
histopathological diagnosis concluded with 7 dentigerous cysts, 1 inflammatory
cyst, and one keratocyst. Among the 5 patients diagnosed with dentigerous cysts
who had mixed dentition, total reossification was achieved within 5 to 7
months. For the rest of the patients, a second surgical time was indicated
after partial regression. Total reossification was noted for keratocyst patient
after a second enucleation.
Conclusion: The clinical and radiographic investigations
demonstrated the effectiveness of Marsupialization and decompression in the
treatment of maxillary and mandibular cystic lesions. It reduced the size of
lesions avoiding injury to adjacent structures. The reclassification of the
keratocyst as an odontogenic cyst stimulates the choice of conservative
treatments and reinforces the continuity of investigations on decompression and
complementary treatments. However, secondary surgery is recommended.
Author
(s) Details
Belkacem Chebil
Raouaa
Department of Oral Medicine and Oral Surgery, Sahloul Hospital, Dental
University, Monastir University, Tunisia.
Amri Afef
Department of Oral Medicine and Oral Surgery, Sahloul Hospital, Dental
University, Monastir University, Tunisia.
Oualha Lamia
Department of Oral Medicine and Oral Surgery, Sahloul Hospital, Dental
University, Monastir University, Tunisia.
Douki Nabiha
Department of Oral Medicine and Oral Surgery, Sahloul Hospital, Dental
University, Monastir University, Tunisia.
Please see the book here:- https://doi.org/10.9734/bpi/nvmms/v10/3397
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