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Grün P, Schiepek T, Pfaffeneder-Mantai F, Bandura AS, Hatamikia S, Turhani D. Clinical and radiological documentation of complete remodeling of the mandibular bone after the enucleation of a large odontogenic keratocyst: 15 years follow-up of a unique case - A case report. Int J Surg Case Rep 2024; 119:109752. [PMID: 38735217 PMCID: PMC11107345 DOI: 10.1016/j.ijscr.2024.109752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 05/09/2024] [Indexed: 05/14/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Odontogenic keratocysts (OKC) are benign intraosseous cysts with expansive growth. They account for approximately 7.8 % of all jaw cysts and have a high recurrence rate. Herein, we present a minimally invasive approach for the surgical treatment of a remarkable variation of OKC with a 15-year radiological and clinical follow-up. PRESENTATION OF THE CASE We present the case of a 42-year-old female patient with a large cyst in the mandible between teeth 35 and 45, who reported spontaneous swelling and paresthesia of the lower lip. Radiological imaging is crucial for treatment planning. The cyst was surgically treated with a single enucleation combined with adjuvant therapy to minimise recurrence. A titanium plate was inserted because of the size of the defect. Recurrence was observed one year later and treated with single enucleation and adjuvant therapy. After 15 years, complete healing, no signs of recurrence, and complete remodeling of the mandible were observed. CLINICAL DISCUSSION The treatment of OKC remains the subject of varying approaches in the literature due to the lack of established general guidelines. One treatment option is single enucleation combined with adjuvant therapy to minimise recurrence, which can result in complete clinical and radiological remodeling of the bone. CONCLUSION Direct enucleation combined with adjuvant therapy is a practical approach for treating large OKCs. It is associated with less morbidity and burden on the patient than enucleation with prior decompression or radical resection. Additionally, it shows no deficits in bone defect healing.
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Affiliation(s)
- Pascal Grün
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500 Krems, Austria
| | - Tim Schiepek
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500 Krems, Austria
| | - Florian Pfaffeneder-Mantai
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500 Krems, Austria; Division for Chemistry and Physics of Materials, Department of Medicine, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500 Krems, Austria
| | - Anna Sophia Bandura
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500 Krems, Austria
| | - Sepideh Hatamikia
- Medical Image Analysis & Artificial Intelligence (MIAAI) group, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstrasse 124, 3500 Krems, Austria; Austrian Center for Medical Innovation and Technology (ACMIT), Viktor Kaplan-Straße 2/1, 2700 Wiener Neustadt, Austria
| | - Dritan Turhani
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500 Krems, Austria.
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Niu G, Zhang G, Chen JM, Wang T, Wu Y, Lu YG, Lin LS. A 3-year follow-up clinical study on the preservation for vitality of involved tooth in jaw cysts through an innovative method. Sci Rep 2024; 14:128. [PMID: 38168126 PMCID: PMC10761841 DOI: 10.1038/s41598-023-50523-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 12/20/2023] [Indexed: 01/05/2024] Open
Abstract
Jaw cysts commonly affect the oral and maxillofacial region, involving adjacent tooth roots. The management of these teeth, particularly regarding root canal therapy and apicoectomy, lacks consensus. This study introduces a novel treatment concept and refined surgical approach to preserve pulp viability in teeth involved in jaw cysts. The objective was to investigate the effectiveness and potential benefits of this approach over a 36-month follow-up period. A conservative management approach prioritized vitality preservation, reserving root canal treatment and apicectomy for cases with post-operative discomfort. A comprehensive follow-up of 108 involved teeth from 36 jaw cyst cases treated with the modified method was conducted. Clinical observation, X-ray imaging, cone-beam computed tomography (CBCT), and pulp vitality testing assessed changes in cyst size, tooth color, pulp vitality, root structure, and surrounding alveolar bone. After 36 months, our modified surgical approach successfully preserved tooth vitality in 84 involved teeth. Adverse symptoms in 19 teeth, such as redness, swelling, fistula, and pain, resolved with postoperative root canal therapy. Follow-up was lost for five teeth in two cases. No cyst recurrences were observed, and in 34 cases, the bone cavity gradually disappeared, restoring normal bone density during long-term follow-up. Our modified surgical method effectively preserves tooth vitality in jaw cysts. This innovative approach has the potential to improve the management of teeth involved in jaw cysts.
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Affiliation(s)
- Gang Niu
- Department of Maxillofacial Surgery, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Middle Road, Fuzhou, 350001, China
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - GongHang Zhang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- School of Stomatology, Fujian Medical University, Fuzhou, 350004, China
| | - Jia-Min Chen
- Department of Maxillofacial Surgery, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Middle Road, Fuzhou, 350001, China
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Tao Wang
- Department of Maxillofacial Surgery, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Middle Road, Fuzhou, 350001, China
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Ye Wu
- Department of Maxillofacial Surgery, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Middle Road, Fuzhou, 350001, China
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - You-Guang Lu
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China.
- Department of Preventive Dentistry, Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Middle Road, Fuzhou, 350001, China.
| | - Li-Song Lin
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China.
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
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Guo Z, Zhang J, Gong Z, Jing S. Correlation of factors associated with postoperative infection in patients with malignant oral and maxillofacial tumours: a logistic regression analysis. Br J Oral Maxillofac Surg 2019; 57:460-465. [DOI: 10.1016/j.bjoms.2019.04.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 04/04/2019] [Indexed: 11/25/2022]
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