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Yang R, Lin X, Zhang W, Gokavarapu S, Lin C, Ren Z, Hu Y, Cao W, Ji T. Unicystic ameloblastoma: A retrospective study on recurrent factors from a single institute database. Oral Dis 2024; 30:1475-1482. [PMID: 36564985 DOI: 10.1111/odi.14477] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 12/01/2022] [Accepted: 12/20/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Unicystic ameloblastomas are a variant of ameloblastoma with a definite recurrence rate because of the biological behaviours of the tumour. The risk factors associated with disease recurrence were analysed in this retrospective study. METHODS A total of 132 patients with primary unicystic ameloblastoma reported in a tertiary hospital from 2005 to 2015 were analysed to identify the clinic-pathological and radiological factors associated with recurrence using univariate and multivariate Cox regression analyses. RESULTS The mean volume was 30.54cm3 ± 12.55 cm3, and this value differed significantly according to recurrence (p < 0.001). Root resorption and bone cortex/soft tissue invasion were also significantly associated with recurrence among unicystic ameloblastoma patients (p = 0.017 vs. p < 0.001, respectively). A new stage classification system was developed to predict disease recurrence of patients. The multivariate Cox regression analysis revealed that the new stage classification system was the only predictor of disease recurrence in unicystic ameloblastoma patients (p < 0.001), regardless of root resorption, position and site characteristics. CONCLUSIONS Volume, root resorption and bone cortex/soft tissue invasion were risk factors for disease recurrence among unicystic ameloblastoma patients. The new stage classification was an independent predictor of disease recurrence in patients with unicystic ameloblastoma.
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Affiliation(s)
- Rong Yang
- Department of Oral and Maxillofacial - Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Xiaohu Lin
- Department of Oral and Maxillofacial - Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Wenming Zhang
- Department of Oral and Maxillofacial - Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Sandhya Gokavarapu
- Department of Oral and Maxillofacial - Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Chengzhong Lin
- Department of Oral and Maxillofacial - Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Zhenhu Ren
- Department of Oral and Maxillofacial - Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Yongjie Hu
- Department of Oral and Maxillofacial - Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Wei Cao
- Department of Oral and Maxillofacial - Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Tong Ji
- Department of Oral and Maxillofacial - Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
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Silva VT, de Campos WG, Leone C, de Abreu Alves F, Lemos CA. Which devices can be used to decompress odontogenic cystic lesions in the oral cavity? A systematic review. Br J Oral Maxillofac Surg 2024; 62:252-258. [PMID: 38458909 DOI: 10.1016/j.bjoms.2023.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 12/18/2023] [Accepted: 12/26/2023] [Indexed: 03/10/2024]
Abstract
Odontogenic cysts are bony lesions in the jaws that can reach large sizes. Decompression, a technique that helps in their surgical treatment, aims to reduce their size. We aimed to conduct a systematic review of the main types of device used for the decompression of odontogenic cysts and to analyse the indications, types, advantages, and disadvantages of the devices used. We searched PubMed, Science Direct, LILACS, EMBASE, and Web of Science until February 2023, with no time restriction. We considered studies with a minimum of 10 patients published only in English, those that reported cases and case series, randomised clinical trials of the decompression of odontogenic cysts, and the types of devices used during the decompression period. All reported odontogenic cysts had to have been confirmed by biopsy in their respective publications. We found 713 articles in the selected databases. After removing duplicates, 499 remained. After reading the titles and abstracts, we excluded 461 articles so 38 remained. Nine studies were selected for the review, totalling 244 patients. A total of 206 lesions were identified and confirmed by anatomopathological examination: 123 keratocysts, 40 dentigerous cysts, 34 radicular cysts, one cyst of epithelial origin but without specification, and eight unicystic ameloblastomas. Although we did not find out which device is best for the decompression of odontogenic cysts, our findings show that those that are most effective should be as comfortable as possible and should remain in place. They should have stability in the oral cavity and be easy for the patient to clean.
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Affiliation(s)
- Vinícius Teixeira Silva
- Department of Oral Medicine, Faculdade de Odontologia, Universidade de São Paulo, São Paulo, Brazil.
| | | | - Caroline Leone
- Department of Oral Medicine, Faculdade de Odontologia, Universidade de São Paulo, São Paulo, Brazil
| | - Fábio de Abreu Alves
- Department of Oral Medicine, Faculdade de Odontologia, Universidade de São Paulo, São Paulo, Brazil
| | - Celso Augusto Lemos
- Department of Oral Medicine, Faculdade de Odontologia, Universidade de São Paulo, São Paulo, Brazil.
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Chen B, Liu Y, Ke C, Xu S. A case of concentrated growth factor gel to fill the defect after large jaw cyst enucleation. Clin Case Rep 2023; 11:e8272. [PMID: 38046807 PMCID: PMC10689290 DOI: 10.1002/ccr3.8272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/18/2023] [Accepted: 11/09/2023] [Indexed: 12/05/2023] Open
Abstract
Management of large jaw cyst is challenging since high risks including pathologic fracture, limited opening, and insufficient bone healing occur after enucleation. The current case of concentrated growth factor (CGF) gel to fill defect after enucleation of large jaw cyst is rare. A 12-year-old boy with pain and swelling for 4 months in the left mandible region made a medical consultation at our hospital. Computerized tomography scan indicated that cystic lesion was found in the left mandible region. In this case, we present a patient with large jaw cyst (31 mm × 44 mm × 53 mm) who received enucleation followed by CGF gel filling the defect. The patient was discharged after 13 days without discomfort symptoms. The lesion size was reduced significantly at 1-month re-examination. No abnormality was detected in maxillofacial region at 1-year re-examination. Application of CGF gel is one of the possible options for filling defect after jaw cyst enucleation.
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Affiliation(s)
- Binxiong Chen
- Department of Burn and Plastic SurgeryShenzhen Longhua District Central HospitalShenzhenGuangdongChina
| | - Yueming Liu
- Department of Burn and Plastic SurgeryShenzhen Longhua District Central HospitalShenzhenGuangdongChina
| | - Changneng Ke
- Department of Burn and Plastic SurgeryShenzhen Longhua District Central HospitalShenzhenGuangdongChina
| | - Shi Xu
- Department of Burn and Plastic SurgeryShenzhen Longhua District Central HospitalShenzhenGuangdongChina
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4
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Wongrattanakarn S, Trachoo V, Kaboosaya B, Charoenlarp P, Chongruangsri NN, Promoppatum P. Factors affecting the reduction rate of odontogenic cysts after decompression based on 3-dimensional volumetric analysis. Imaging Sci Dent 2023; 53:313-323. [PMID: 38174041 PMCID: PMC10761289 DOI: 10.5624/isd.20230083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/14/2023] [Accepted: 07/21/2023] [Indexed: 01/05/2024] Open
Abstract
Purpose This study aimed to investigate the potential factors that could affect the reduction rate of odontogenic cysts following decompression using cone-beam computed tomography (CBCT) for 3-dimensional volumetric analysis. Materials and Methods The study sample consisted of CBCT images of 41 individuals who underwent decompression of odontogenic cysts at the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, between 2010 and 2022. Preoperative and postoperative CBCT results were collected, and a volumetric analysis was conducted to evaluate the differences in the reduction rate and the percentage of volume reduction of cystic lesions based on different parameters. Correlations between these parameters were analyzed to determine associations. Results In this study, the average time of decompression for odontogenic cysts was 316 days. Males demonstrated a higher reduction rate than females (P<0.05). The reduction rate was directly proportional to initial cyst volume, with higher reduction rates for cysts with large initial volume than those with small initial volume (P<0.05). Spearman's rank correlation coefficient indicated a weak positive correlation between the initial cyst volume and the duration of decompression. Additionally, a strong positive correlation was observed between the initial volume and the reduction rate. Conclusion Knowledge of the reduction rate of odontogenic cysts is vital for surgeons to evaluate the duration of decompression before enucleation and to determine a definitive treatment plan. Sex and initial lesion volume had significant effects on the reduction rate.
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Affiliation(s)
- Sarawut Wongrattanakarn
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Vorapat Trachoo
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Boosana Kaboosaya
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Pornkawee Charoenlarp
- Department of Radiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Net-nada Chongruangsri
- Somdech Phra Pinklao Hospital, Naval Medical Department, Royal Thai navy, Bangkok, Thailand
| | - Patcharapit Promoppatum
- Department of Mechanical Engineering, Faculty of Engineering, King Mongkut’s University of Technology Thonburi, Bangkok, Thailand
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Zhang Y, Xing A, He J, Wang F, Li Z, Sun B. Curettage combined with bone cavity opening reduces recurrence of the mandibular conventional ameloblastoma and effectively preserves the mandible: a retrospective study. BMC Oral Health 2023; 23:885. [PMID: 37986074 PMCID: PMC10658885 DOI: 10.1186/s12903-023-03660-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 11/12/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Patients with mandibular conventional ameloblastoma undergoing radical surgical treatment experience greater trauma and often find it challenging to accept, whereas conservative therapy is associated with a higher recurrence rate. In this study, we have improved traditional conservative treatment for mandibular conventional ameloblastoma by curettage combined with bone cavity opening (Cur/BCO). This retrospective study aimed to evaluate the effectiveness of the Cur/BCO treatment by comparing its recurrence rate and bone mineral density (BMD) growth rate with the traditional conservative treatment approach. METHODS A total of 40 patients, meeting the study's inclusion and exclusion criteria from 2012 to 2020, were screened, with 20 in the modified group and 20 in the traditional group. ImageJ (RRID: SCR_003070) software was employed for measuring image indices. All data were analyzed using T-test, Chi-square test and Fisher exact test in SPSS 26.0 (p = 0.05). RESULTS The incidence of recurrence was significantly lower in the modified group, at only 5%, compared to 35% in the traditional group (p < 0.05). Regarding bone mineral density (BMD) growth rate, the average value in the modified group was 0.0862 ± 0.2302 (/month), significantly higher than the average value of 0.0608 ± 0.2474 (/month) in the traditional group (p < 0.05). CONCLUSIONS In this study, it was found that the recurrence rate of the modified conservative treatment (Cur/BCO) was lower than that of the traditional conservative treatment for managing mandibular conventional ameloblastoma. Furthermore, the BMD growth rate was quicker in the modified group. Thus, Cur/BCO could be considered as a viable option for the conservative treatment of mandibular conventional ameloblastoma.
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Affiliation(s)
- Yuan Zhang
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Jilin University, Qinghua Road 1500, Changchun, Jilin Province, 130021, P. R. China
| | - Aili Xing
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Jilin University, Qinghua Road 1500, Changchun, Jilin Province, 130021, P. R. China
| | - Jingya He
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Jilin University, Qinghua Road 1500, Changchun, Jilin Province, 130021, P. R. China
| | - Feng Wang
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Jilin University, Qinghua Road 1500, Changchun, Jilin Province, 130021, P. R. China
| | - Zhongrui Li
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Jilin University, Qinghua Road 1500, Changchun, Jilin Province, 130021, P. R. China
| | - Bin Sun
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Jilin University, Qinghua Road 1500, Changchun, Jilin Province, 130021, P. R. China.
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Demir E, Gunhan O. Conservative treatment of a unicystic ameloblastoma by marsupialization with a favorable response: A case report and review of the literature. Dent Res J (Isfahan) 2023. [DOI: 10.4103/1735-3327.367909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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Pei J, Zhao S, Chen H, Wang J. Management of radicular cyst associated with primary teeth using decompression: a retrospective study. BMC Oral Health 2022; 22:560. [PMID: 36457003 PMCID: PMC9713984 DOI: 10.1186/s12903-022-02572-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 11/08/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Radicular cysts arising from primary teeth are rare. Enucleation and marsupialization or decompression are treatment approach to odontogenic cysts. Decompression known to achieve good results in various cysts is widely used in clinic. This study aims to evaluate the efficiency of decompression in reducing radicular cysts associated with primary teeth in children. METHODS Cases of radicular cysts associated with primary teeth treated by decompression were reviewed in the present study. Clinical information and radiologic data of pre and post decompression were measured and analyzed. RESULTS Twenty-three patients treated for 25 cysts were included. All lesions with mean initial area 3.66 ± 2.00 cm2 were reduced after decompression time ranging 2 to 10 months. Mean rate of reduction was 0.77 ± 0.44 cm2/mo and large lesions (> 3.5 cm2) had a significantly higher reduction rate compared to smaller ones (< 3.5 cm2) (P < 0.00). All effected succedaneous teeth erupted after treatment at follow-up while 12 (46%) of them had root development problems. CONCLUSIONS Decompression represents superiority as an effective and less invasive treatment in radicular cysts associated with primary teeth. TRIAL REGISTRATION This study was retrospectively registered in the Ethics Committee of Ninth People's Hospital Affiliated with Shanghai JiaoTong University School of Medicine (No.SH9H-2022-T158-1).
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Affiliation(s)
- Jun Pei
- grid.412523.30000 0004 0386 9086Department of Pediatric Dentistry, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China ,grid.16821.3c0000 0004 0368 8293College of Stomatology, Shanghai Jiao Tong University, Shanghai, China ,grid.412523.30000 0004 0386 9086National Center for Stomatology; National Clinical Research Center for Oral Diseases, Shanghai, China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Shimin Zhao
- grid.412523.30000 0004 0386 9086Department of Pediatric Dentistry, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China ,grid.16821.3c0000 0004 0368 8293College of Stomatology, Shanghai Jiao Tong University, Shanghai, China ,grid.412523.30000 0004 0386 9086National Center for Stomatology; National Clinical Research Center for Oral Diseases, Shanghai, China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Hui Chen
- grid.412523.30000 0004 0386 9086Department of Pediatric Dentistry, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China ,grid.16821.3c0000 0004 0368 8293College of Stomatology, Shanghai Jiao Tong University, Shanghai, China ,grid.412523.30000 0004 0386 9086National Center for Stomatology; National Clinical Research Center for Oral Diseases, Shanghai, China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Jun Wang
- grid.412523.30000 0004 0386 9086Department of Pediatric Dentistry, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China ,grid.16821.3c0000 0004 0368 8293College of Stomatology, Shanghai Jiao Tong University, Shanghai, China ,grid.412523.30000 0004 0386 9086National Center for Stomatology; National Clinical Research Center for Oral Diseases, Shanghai, China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Stomatology, Shanghai, China
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Porte JP, Guerrero LM, Rivera B, Wiscovitch A, Castro-Núñez J. Odontogenic Keratocyst: A Clinical Entity With Favorable Response to Active Decompression and Distraction Sugosteogenesis. Craniomaxillofac Trauma Reconstr 2022; 15:268-274. [PMID: 36387313 PMCID: PMC9647388 DOI: 10.1177/19433875211035237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2023] Open
Abstract
Objective The purpose of this study was to determine the usefulness of active decompression and distraction sugosteogenesis (ADDS) for the management of non-syndromic odontogenic keratocysts (OKC). Materials and Methods A retrospective case series study was designed and implemented. The study observed the Declaration of Helsinki on medical protocol and ethics and it was approved by the university's Institutional Review Board (IRB). The medical files of all patients who underwent ADDS for OKCs of the jaws at the Department of Oral and Maxillofacial Surgery of a tertiary university-affiliated medical center were reviewed. Data were collected on patient's age, gender, presenting signs and symptoms, lesion location, locularity, pre-ADDS, size of the lesion, post-ADDS, pain, days with bloody discharge and/or proteinaceous fluid inside the system's external unit, days to achieve hermetic seal, size of the lesion 2 weeks after ADDS, percentage of reduction, patient's complaints/complications, and follow-up period. Pre- and post-ADDS panoramic radiographs were reviewed for reduction parameters. Results Six patients, 5 males and 1 female, with an average age of 45.16 years (range 16-74 years) were studied. ADDS was performed during 4 weeks in all patients. During the therapy, the extraoral unit collected blood during 2.83 days in average. In average, after the third day, the cystic cavity started to drain a proteinaceous fluid for about 9.33 days (range 6-15 days). The average pre-ADDS Standard Lesional Area Index (SLAI) was 18.17 cm2 (range 4.40 cm2-34.58 m2) and, after 2 weeks of ADDS, the average SLAI was 5.47 cm2 (range 0.49 cm2-15.39 cm2). The average percentage of reduction, after 2 weeks, was 73.93% (range 55.49%-97.51%), which yielded an overall good reaction of OKCs to ADDS. No significant reduction of the lesions was observed from week 2 to week 4, when ADDS ceased. All lesions were enucleated after 3 months. After an average of 14 months of follow-up (12 to 17 months), no signs of recurrence have been observed.
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Affiliation(s)
- Juan-Pablo Porte
- Oral and Maxillofacial Surgery
Residency Program, School of Dental Medicine, University of Puerto Rico–Medical
Sciences Campus, San Juan, Puerto Rico
| | - Lidia M. Guerrero
- Oral and Maxillofacial Surgery
Residency Program, School of Dental Medicine, University of Puerto Rico–Medical
Sciences Campus, San Juan, Puerto Rico
| | - Bonifacio Rivera
- Oral and Maxillofacial Surgery
Residency Program, School of Dental Medicine, University of Puerto Rico–Medical
Sciences Campus, San Juan, Puerto Rico
| | - Andres Wiscovitch
- Oral and Maxillofacial Surgery
Residency Program, School of Dental Medicine, University of Puerto Rico–Medical
Sciences Campus, San Juan, Puerto Rico
| | - Jaime Castro-Núñez
- Oral and Maxillofacial Surgery
Residency Program, School of Dental Medicine, University of Puerto Rico–Medical
Sciences Campus, San Juan, Puerto Rico
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Lešin A, Galić I, Tadin A, Vilović K, Jerković D. Treatment of Inflammatory Dentigerous Cyst Using a Surgical T Drain in a Child. Eur J Dent 2022. [PMID: 36220112 DOI: 10.1055/s-0042-1756688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
Dentigerous cysts are rarely reported in young children. They are usually asymptomatic and only identified when becoming significantly large. Treatment by enucleation may damage structures like the inferior alveolar nerve, maxillary sinus, or permanent teeth, thus reducing the child's quality of life. Therefore, conservative surgical treatment such as decompression is indicated. This case report describes the treatment and subsequent complete regression of an inflammatory dentigerous cyst based on the decompression method using a customized surgical tube in a 10-year-old girl. The innervation was preserved, and permanent teeth erupted.
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Affiliation(s)
- Antonella Lešin
- Department of Maxillofacial Surgery, University Hospital of Split, Split, Croatia
| | - Ivan Galić
- Department of Maxillofacial Surgery, University Hospital of Split, School of Medicine, University of Split, Split, Croatia
| | - Antonija Tadin
- Department of Restorative Dental Medicine and Endodontics, School of Medicine, University of Split, Split, Croatia
| | - Katarina Vilović
- Department of Anatomy, Department of Pathology, University Hospital of Split, School of Medicine, University of Split, Split, Croatia
| | - Daniel Jerković
- Department of Maxillofacial Surgery, University Hospital of Split, School of Medicine, University of Split, Split, Croatia
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Zhang J, Yu Y, Miao R, Ren J, Jiang Y, Jing W. Treatment effect analysis of curettage for jaw cysts based on volumetric assessment and image registration. J Craniomaxillofac Surg 2022; 50:S1010-5182(22)00132-9. [PMID: 36270886 DOI: 10.1016/j.jcms.2022.09.005] [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: 06/27/2022] [Revised: 09/05/2022] [Accepted: 09/21/2022] [Indexed: 11/29/2022] Open
Abstract
The study was conducted to develop a visual and intuitive quantitative evaluation method for maxillary cystic lesions after curettage. Mimics 16.0 and Geomagic Studio 2013 were used to form a precise reconstruction of the cystic lesion morphology of 60 cases; the average reduction rates and 95% confidence interval were calculated. Computed tomography (CT) registration was performed before and after surgery to observe morphology features of the bone regeneration of the cystic area. The average reduction rates (RR) of the cysts after curettage were (43.56 ± 16.79)%, (54.33 ± 17.15)% and (68.53 ± 15.99)% at 3 months, 6 months and 12 months after surgery, respectively. The average monthly reduction rates (MRR) were (12.07 ± 4.35)%, (8.16 ± 2.84)% and (5.35 ± 1.52)% at 3 months, 6 months and 12 months after surgery, respectively. Correlation analysis by comparing with each group showed that the effect of sex and age in the 3-month group and the initial size in the 12-month group on RR and MRR were statistically significant. Within the limitations of the study it seems that the chosen approach for quantitative evaluation of the therapeutic effect of curettage for jaw cystic lesions might facilitate visual and quantitative follow-up of cyst curettage and timely detection of recurrence.
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Affiliation(s)
- Jiankang Zhang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China School & Hospital of Stomatology, Sichuan University, No. 14, 3rd Section of Renmin South Road, Chengdu, 610041, China
| | - Yunbo Yu
- Stomatological Hospital of Chongqing Medical University, Chongqing, 401147, China
| | - Rong Miao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China School & Hospital of Stomatology, Sichuan University, No. 14, 3rd Section of Renmin South Road, Chengdu, 610041, China
| | - Jiayin Ren
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral Radiology, West China School & Hospital of Stomatology, Sichuan University, No. 14, 3rd Section of Renmin South Road, Chengdu, 610041, China
| | - Yichen Jiang
- Stomatological Hospital of Chongqing Medical University, Chongqing, 401147, China
| | - Wei Jing
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China School & Hospital of Stomatology, Sichuan University, No. 14, 3rd Section of Renmin South Road, Chengdu, 610041, China.
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11
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Kivovics M, Pénzes D, Moldvai J, Mijiritsky E, Németh O. A custom-made removable appliance for the decompression of odontogenic cysts fabricated using a digital workflow. J Dent 2022; 126:104295. [PMID: 36116543 DOI: 10.1016/j.jdent.2022.104295] [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: 03/31/2022] [Revised: 08/29/2022] [Accepted: 09/14/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES This case series aimed to assess the feasibility of a custom-made decompression appliance fabricated using a digital workflow to decompress odontogenic cysts. Additionally, the treated cysts were assessed for volumetric changes. METHODS A three-dimensional (3D) reconstruction software (CoDiagnostiX version 10.4) was used to obtain the master cast STL (Standard Tessellation Language) file by placing a customized virtual implant to create a recess for the tube of the decompression device. The decompression appliance was planned using Dental Wings Open Software (DWOS). Following rapid prototyping, the tube of the appliance was perforated using round burs. In cases where the appliances were designed to replace teeth, denture teeth were added using the conventional workflow. The appliances were delivered on the day of the cystostomy. Following decompression, cyst enucleation was performed. Cyst volume was assessed by manual segmentation of pre- and post-operative cone-beam computed tomography (CBCT) reconstructions using slice-by-slice boundary drawing with a scissors tool in the 3DSlicer 4.10.2 software. Percentage of volume reduction was calculated as follows: volume reduction/pre-operative volume × 100. RESULTS Six odontogenic cysts in six patients (5 male, 1 female; age 40 years, range: 15-49 years) with a pre- and post-operative cyst volume of 5597 ± 3983 mm3 and 2330 ± 1860 mm3 respectively (p < 0.05) were treated. Percentage of volume reduction was 58.84 ± 13.22 % following a 6-month-long decompression period. CONCLUSIONS The digital workflow described in this case series enables the delivery of decompression appliances at the time of cystostomy, thus effectively reducing the volume of odontogenic cysts. The resulting bone formation established a safe zone around the anatomical landmarks; therefore, during enucleation surgery, complications to these landmarks can be avoided.
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Affiliation(s)
- Márton Kivovics
- Department of Community Dentistry, Semmelweis University, Szentkirályi utca 40. 1088 Budapest, Hungary.
| | - Dorottya Pénzes
- Department of Community Dentistry, Semmelweis University, Szentkirályi utca 40. 1088 Budapest, Hungary.
| | - Júlia Moldvai
- Department of Community Dentistry, Semmelweis University, Szentkirályi utca 40. 1088 Budapest, Hungary.
| | - Eitan Mijiritsky
- Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel Aviv 64239, Israel,; Goldschleger School of Dental Medicine, Sackler School of Medicine, Tel-Aviv University, Tel Aviv 39040, Israel.
| | - Orsolya Németh
- Department of Community Dentistry, Semmelweis University, Szentkirályi utca 40. 1088 Budapest, Hungary.
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12
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Xiong X, Li C, Guo L, Wu Y, Wang Y, Song X. Effect of Intracapsular Pressure on Decompression Effectiveness. Int Dent J 2022; 72:839-846. [DOI: 10.1016/j.identj.2022.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 06/24/2022] [Accepted: 06/25/2022] [Indexed: 12/01/2022] Open
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Mustansir-Ul-Hassnain S, Chandavarkar V, Mishra MN, Patil PM, Bhargava D, Sharma R. Histopathologic and immunohistochemical findings of odontogenic jaw cysts treated by decompression technique. J Oral Maxillofac Pathol 2021; 25:272-278. [PMID: 34703121 PMCID: PMC8491353 DOI: 10.4103/0973-029x.325126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 05/18/2021] [Accepted: 08/04/2021] [Indexed: 11/04/2022] Open
Abstract
Context Odontogenic cysts are among the most common lesions to affect the oral and maxillofacial region. Cysts are capable of causing significant bony disfigurement, tooth displacement and pathological fractures. Several surgical approaches exist for the management of larger cysts of the jaws. These include enucleation, marsupialization and decompression. Aims 1. Analysis of histopathologic findings in odontogenic cysts before and after decompression2. Analysis of Ki-67 expression in odontogenic jaw cysts before and after decompression. Settings and Design Decompression technique was used for the treatment of 10 cases of odontogenic cysts in the study. Incisional biopsies of cystic lining (pretreatment) and corresponding excisional biopsies (posttreatment) were received for histopathologic and immunohistochemical examination. Subjects and Methods Hematoxylin and eosin stain was used for histopathologic findings, and Ki-67 was used for immunohistochemical findings using antibody Ki-67 in fresh tissue samples. Results Overall, radicular cysts, dentigerous cysts, and sialo-odontogenic cyst contained fewer Ki-67 + cells than odontogenic keratocysts. The average scores were found to be 2.2 and 1 for before and after decompression, respectively. A statistically significant difference was observed between the two groups. The two-tailed P value was found to be <0.0001. The confidence interval was found to be 95%. Conclusions The proliferative activity evaluated by Ki-67 marker was greater in predecompression epithelial lining compared to postdecompression. Our study infers that proliferative rate of the cystic epithelial lining is significantly diminished after decompression.
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Affiliation(s)
| | - Vidyadevi Chandavarkar
- Department of Oral and Maxillofacial Pathology and Oral Microbiology, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Mithilesh Narayan Mishra
- Department of Oral and Maxillofacial Pathology and Oral Microbiology, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Pavan Manohar Patil
- Department of Oral and Maxillofacial Surgery, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Deepak Bhargava
- Department of Oral and Maxillofacial Pathology and Oral Microbiology, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Ritika Sharma
- Department of Oral and Maxillofacial Pathology and Oral Microbiology, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India
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Conservative Approach in the Management of Large Periapical Cyst-Like Lesions. A Report of Two Cases. ACTA ACUST UNITED AC 2021; 57:medicina57050497. [PMID: 34068934 PMCID: PMC8156608 DOI: 10.3390/medicina57050497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 04/28/2021] [Accepted: 05/13/2021] [Indexed: 11/17/2022]
Abstract
Background and Objectives: Periapical cystic lesions are a pathology frequently addressed to endodontic specialists. Although their therapy is still not standardized, the treatment should be as conservative as possible and by endodontic means, as they are lesions of endodontic origin. The present case report describes two cases of upper central incisors with large cyst-like periapical lesions, and their one-year follow up. Materials and Methods: Endodontic orthograde treatment was performed under copious irrigation with sodium hypochlorite, in association with calcium hydroxide as an intra-canal medication for both teeth. Root canal filling was achieved in a separate appointment using the continuous wave of condensation technique. A decompression procedure was used in association with endodontic therapy in the second case to reduce the pressure inside the cystic lesion and to allow its drainage, and only because the root canal could not be dried three weeks after medication. Initial cone beam computed tomography (CBCT) investigations, as well as at the one-year follow up, were used to compare the evolution of the lesion. Results: Both cases had a favorable outcome. New bone formation in the periapical region and complete resolution of the lesion was observed at the one-year control in the first case. In the second case, although the lesion was still not completely healed at 12 months, a significant reduction in its size could be observed, showing active signs of healing. Conclusions: Endodontic treatment is the first choice option in the management of teeth with pulpal necrosis and large periapical cystic-like lesions. Decompression is the only surgical procedure recommended when the canals cannot be dried and obturated. Large surgical interventions are unnecessary in cases where endodontic treatment can be performed.
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Berretta LM, Melo G, Mello FW, Lizio G, Rivero ERC. Effectiveness of marsupialisation and decompression on the reduction of cystic jaw lesions: a systematic review. Br J Oral Maxillofac Surg 2021; 59:E17-E42. [PMID: 34749963 DOI: 10.1016/j.bjoms.2021.03.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 03/12/2021] [Indexed: 11/26/2022]
Abstract
In this study, we aimed to systematically review and critically appraise the available literature concerning the effectiveness of marsupialisation and decompression on the reduction of cystic jaw lesions. The 'Preferred Reporting Items for Systematic Reviews and Meta-Analysis' guidelines were followed and the study protocol was registered at the 'International Prospective Register of Systematic Reviews' (CRD42019116099). Six main databases were searched: Embase, LILACS, PubMed, Scopus, The Cochrane Library, and Web of Science. Searches were complemented with three grey literature sources: Google Scholar, ProQuest, and Open Grey. Any reduction measures, compared with preoperative status or other procedures, were considered. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Tool. Thirty-one studies were included, of which five were judged with low, 24 with moderate, and two with high risk of bias. Considering surgical approach, 20 studies assessed the decompression and 11 the marsupialisation technique. Most studies considered these techniques as preliminary treatments, followed by enucleation. From 1088 lesions found, most were odontogenic keratocysts (33.8%), followed by unicystic ameloblastomas (21.0%), dentigerous cysts (20.6%), and radicular cysts (8.4%). Large lesions and younger individuals frequently presented more favourable responses to treatment and anatomical location was not associated with lesion reduction overall. The intervention duration generally ranged between one to two years. In conclusion, marsupialisation and decompression were mostly considered as preliminary treatments, followed by enucleation. Lesion reduction was generally considered insufficient for these techniques to be used as definitive therapies, although benefits concerning the diminished invasiveness of the secondary surgery were often proposed.
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Affiliation(s)
- L M Berretta
- Dental School, Federal University of Santa Catarina - Florianópolis, Santa Catarina, Brazil.
| | - G Melo
- Postgraduate Programme in Dentistry, Federal University of Santa Catarina - Florianópolis, Santa Catarina, Brazil.
| | - F W Mello
- Postgraduate Programme in Dentistry, Federal University of Santa Catarina - Florianópolis, Santa Catarina, Brazil.
| | - G Lizio
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna - Bologna, Italy.
| | - E R C Rivero
- Department of Pathology, Health Sciences Centre, Federal University of Santa Catarina - Florianópolis, Santa Catarina, Brazil.
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16
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Lee SM, Ku JK, Leem DH, Baek JA, Ko SO. Conservative management with Carnoy's solution in ameloblastoma involving two unerupted teeth: a report of two cases. J Korean Assoc Oral Maxillofac Surg 2021; 47:40-46. [PMID: 33632976 PMCID: PMC7925159 DOI: 10.5125/jkaoms.2021.47.1.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 05/29/2019] [Accepted: 06/03/2019] [Indexed: 11/16/2022] Open
Abstract
Marsupialization is widely used as a primary treatment modality for reducing size of large cysts. However, there is no recommendation for specific duration of marsupialization. In addition, Carnoy’s solution usually is applied at the time of enucleation as a fixative agent. In this report, we present an appropriate marsupialization duration of ameloblastoma involving two unerupted teeth. In this present study, marsupialization using a Foley catheter was performed in two cases of ameloblastoma of the mandible involving two adjacent impacted teeth. Carnoy’s solution was applied for 3-5 minutes after enucleation in both patients. Periodically during marsupialization, the size of the radiolucency was measured in panoramic view, and clinical examination was performed. No remarkable paresthesia or soft tissue injury was observed after application of Carnoy’s solution or during follow-up. We recommend 12 to 16 weeks as an adequate marsupialization duration for a large ameloblastoma involving two impacted teeth based on increased radiopacity along the margins of the lesions. Poor oral hygiene was an issue after 12 weeks of marsupialization in one case. There were no remarkable complications with Carnoy’s solution in either case. The Foley tube has a two-way system that is more effective for irrigating the cavity than is the conventional one-way system.
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Affiliation(s)
- Sang Min Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Jeonbuk National University, Jeonju, Korea
| | - Jeong-Kui Ku
- Department of Oral and Maxillofaical Surgery, Section of Dentistry, Armed Forces Capital Hospital, Seongnam, Korea
| | - Dae Ho Leem
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Jeonbuk National University, Jeonju, Korea.,Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
| | - Jin-A Baek
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Jeonbuk National University, Jeonju, Korea.,Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
| | - Seung-O Ko
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Jeonbuk National University, Jeonju, Korea.,Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea.,Institute of Oral Bioscience, School of Dentistry, Jeonbuk National University, Jeonju, Korea
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17
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Haas Jr. O, Betina Belloc. C, Agustín MF, André Xavier Padilha F, Neimar S, Rogério Belle DO. Multimodal Protocol for the Treatment of Odontogenic Keratocysts. Open Dent J 2021. [DOI: 10.2174/1874210602115010011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Purpose:
The aim of this study is to evaluate longitudinally the effectiveness of a multimodal protocol based on decompression followed by enucleation combined with the use of liquid nitrogen under local anesthesia for the treatment of odontogenic keratocysts.
Methods:
Seven patients with a diagnosis of odontogenic keratocyst were evaluated longitudinally to clinical and histological features, and pre- and postoperative radiographs were analyzed. Data were collected on the epidemiological profile of patients and on cysts, including the presence of recurrence, duration of drainage device use, lesion site, and presence of postoperative complications.
Results:
No recurrence was observed during follow-up. Mean follow-up was 59.57 months (range, 18-96 months). No pathological fracture was observed. None of the patients had persistent paresthesia of the inferior alveolar nerve. Substantial reduction in cyst size and epithelial differentiation were observed in all patients after multimodal treatment.
Conclusion:
Based on these results, the multimodal protocol proposed here was effective in the treatment of odontogenic keratocysts by reducing lesion size, avoiding possible damage to adjacent anatomical structures, and allowing a surgical procedure with less morbidity. The longitudinal follow-up of patients showed that this treatment modality is associated with a low recurrence rate compared with alternative therapies.
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18
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Li Y, Li L, Shi J, Tu J, Niu L, Hu X. Positional Changes of Mandibular Canal Before and After Decompression of Cystic Lesions in the Mandible. J Oral Maxillofac Surg 2020; 79:854-862. [PMID: 33166521 DOI: 10.1016/j.joms.2020.10.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 10/04/2020] [Accepted: 10/05/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE Significant displacement of the mandibular canal (MC), which occurs frequently in extensive mandibular cystic lesion cases, may raise the risk of inferior alveolar neurovascular bundle injury in surgery. The aim of the present study was to measure the association between positional changes of the MC and the direction (in the coronal plane) of bone expansion of cystic lesions in the mandible. PATIENTS AND METHODS We performed a retrospective study of patients who had undergone decompression and enucleation surgery from January 2014 to December 2018. Based on coronal planes of cone-beam computerized tomography, the centroids of the expanded mandibles were calculated and considered markers for evaluation of the directions of bone expansion. In addition, the changes in the position of the MC before decompression and enucleation were measured and compared. A Cartesian coordinate system was introduced in this study to illustrate the relationship of positional changes between the displacement of the MC and expansion of the mandible in a straightforward manner. Statistical analysis was performed using the paired t test, unpaired t test, one-way analysis of variance or linear regression as appropriate. RESULTS Thirty-six patients with an average age of 29.8 years (14 men, 22 women) who received treatment of decompression and enucleation for mandibular cystic lesions were included in this study. The MCs were displaced in the direction toward the lower edge of the mandible and opposite to the direction of mandibular expansion. In addition, the MCs were relocated close to their original location by 1.67 ± 1.45 mm (mean ± standard deviation) approximately 1 year after decompression, accounting for 22.66% of the total displacement. CONCLUSIONS In mandibular cystic lesion cases, the MCs tend to displace opposite to the direction of mandibular expansion and relocate less after decompression.
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Affiliation(s)
- Yuncong Li
- Attending Staff, Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Lifeng Li
- Attending Staff, Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Jingyi Shi
- Resident, Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Junbo Tu
- Professor, Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Lin Niu
- Professor, Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Xiaoyi Hu
- Professor, Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
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Cho JY, Kim JW, Kim SB, Ryu J. Decompression of Large Cyst Invading the Mandibular Canal Leading to Reduced Cyst Volume and Increased Mandibular Canal Length. J Oral Maxillofac Surg 2020; 78:1770-1779. [PMID: 32579886 DOI: 10.1016/j.joms.2020.05.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 05/03/2020] [Accepted: 05/14/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The mandibular canal is damaged by the growth of cysts, and remodeling of the mandibular canal is observed as the size of the cyst decreases after decompression procedures. This study aimed to estimate changes in cyst volume and mandibular canal length using cone-beam computed tomography (CBCT) before and after decompression surgery. MATERIALS AND METHODS A retrospective cohort study was conducted in patients with a diagnosis of mandibular cyst invading the mandibular canal between 2012 and 2018. All patients underwent CBCT at the initial visit and after decompression. The predictor variable was the period before decompression and before enucleation surgery. The outcome variables were changes in cyst volume and mandibular canal length, which were evaluated 3-dimensionally. The initial volume of the cyst, initial length of the mandibular canal, and patient's age were set as variables of interest that affected the outcome. RESULTS Decompression was performed in 20 patients (18 male and 2 female patients), and the mean decompression duration was 8.81 ± 2.94 months. The average volume reduction rate after decompression was 60.23%, with an average volume reduction speed of 0.72 mL/month. The average length increase rate after decompression was 50.88%, and the average speed of length increase was 2.68 mm/month. The initial volume of the cyst and initial length of the mandibular canal were the important variables affecting the results. Complete separation of the mandibular canal from the cyst was observed in 11 cases, and incomplete separation was found in 9. CONCLUSIONS Separation from the cyst and regeneration of the mandibular canal using decompression were observed using 3-dimensional CBCT analysis. The results of this study suggest that decompression is effective in separating and preserving important anatomic structures invaded by the cyst.
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Affiliation(s)
- Jin-Yong Cho
- Clinical Associate Professor, Department of Oral and Maxillofacial Surgery, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Jin-Woo Kim
- Resident, Department of Oral and Maxillofacial Surgery, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Sung-Beom Kim
- Clinical Assistant Professor, Department of Oral and Maxillofacial Surgery, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Jaeyoung Ryu
- Clinical Assistant Professor, Department of Oral and Maxillofacial Surgery, Gachon University Gil Medical Center, Incheon, Republic of Korea.
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Consolo U, Bellini P, Melini GM, Ferri A, Lizio G. Analysis of Marsupialization of Mandibular Cysts in Improving the Healing of Related Bone Defects. J Oral Maxillofac Surg 2020; 78:1355.e1-1355.e11. [PMID: 32482564 DOI: 10.1016/j.joms.2020.02.034] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 02/19/2020] [Accepted: 02/19/2020] [Indexed: 01/09/2023]
Abstract
PURPOSE Marsupialization, designed to reduce the mandibular cyst volume, has continued to debated regarding its influence on the healing of the related bone cavity. The aim of the present study was to evaluate the 3-dimensional radiographic variation over time in mandibular odontogenic cystic lesions after marsupialization and assess the correlations between these variations and variables that can affect the procedure. MATERIALS AND METHODS We planned a retrospective cohort study. The predictor variables were the treatment duration, preoperative volume, patient age, histologic type, and number of preoperative residual bony walls. The outcomes variables were the postoperative volume reduction and the daily reduction rate calculated using computed tomography (CT) from before to after marsupialization using software designed for volumetric reconstruction and measurement of cyst-related bone defects. The descriptive and bivariate statistics were computerized, and the significance level was set at P = .05. RESULTS The sample included 15 patients (12 men and 3 women; mean age, 51.6; range, 27 to 85 years) affected by keratocysts (n = 6), dentigerous cysts (n = 6), and radicular cysts (n = 3) who had undergone marsupialization. The median duration of marsupialization was 406 days (25th to 75th percentile, 276 to 519). The mean ± standard deviation (SD) pre- and postdecompression volumes were 6,908.27 ± 2,669.058 and 2,468.13 ± 1,343.517 mm3, respectively (P < 0.001), and the mean ± SD percentage of reduction was 63.90 ± 13.12%. The volume decrease in the bone defects correlated positively with the treatment duration (P = .009) and preoperative volume (P < .001). However, no correlation was found with the other variables (P > .05) nor between the daily reduction rate and other variables (P > .05). CONCLUSIONS Marsupialization appears useful in improving the healing of cyst-related bone defects in mandibles, especially larger defects. Further studies with a wider sample size would add more knowledge to this topic.
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Affiliation(s)
- Ugo Consolo
- Professor, Division of Maxillofacial Surgery, Department of Surgery, Medicine, Dentistry, and Morphological Sciences with Transplant Surgery, Oncology, and Regenerative Medicine Relevance, School of Dentistry, University of Modena and Reggio Emilia, Modena, Italy
| | - Pierantonio Bellini
- Researcher, Department of Surgery, Medicine, Dentistry, and Morphological Sciences with Transplant Surgery, Oncology, and Regenerative Medicine Relevance, School of Dentistry, University of Modena and Reggio Emilia, Modena, Italy
| | - Gian Marco Melini
- Postgraduate Student, Department of Surgery, Medicine, Dentistry, and Morphological Sciences with Transplant Surgery, Oncology, and Regenerative Medicine Relevance, School of Dentistry, University of Modena and Reggio Emilia, Modena, Italy
| | - Agnese Ferri
- Scholar, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Giuseppe Lizio
- Resident, Unit of Dentistry and Maxillofacial Surgery, Policlinico di Modena Hospital, Modena, Italy; Research Assistant, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
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Abstract
INTRODUCTION Odontogenic cysts are defined as those cysts that arise from odontogenic epithelium and occur in the tooth-bearing regions of the jaws. Cystectomy, marsupialization, or decompression of odontogenic cyst are the most common treatments proposed for this pathology. The aim of this study is to retrospectively evaluate the result of decompression based on the volumetric reduction of the cystic cavity and new bone formation by cone beam computerized tomography (CBCT). METHODS The 16 patients affected by a large odontogenic mandibular cyst were enrolled in the study. All the patients underwent a surgical decompression of the cyst followed by the enucleation after a follow-up ranging from 6 to 9 months according to the volume's reduction and new bone formation. All the patients were evaluated with a CBCT before and after the surgical decompression to measure and analyze the percentage of reduction of the cystic volume before proceeding with the enucleation. RESULTS The decompression of the cyst showed a reduction of the cystic volume ranging from 38.2% to 54.4% proportionally to the treatment duration. The highest percentage of volume reduction observed was 54.4% in 1 patient followed-up for 9 months, before the surgical enucleation. CONCLUSION In our experience, the decompression seems to be the most suitable technique for the primary treatment of large odontogenic cyst of the jaws followed by the enucleation after 6 to 9 months. The CBCT is an objective method to evaluate the cystic volume reduction after the decompression and helps the surgeon with the surgical planning.
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Sigua-Rodriguez EA, Goulart DR, Sverzut A, Asprino L, de Moraes M. Is Surgical Treatment Based on a 1-Step or 2-Step Protocol Effective in Managing the Odontogenic Keratocyst? J Oral Maxillofac Surg 2019; 77:1210.e1-1210.e7. [DOI: 10.1016/j.joms.2019.02.040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 02/18/2019] [Accepted: 02/21/2019] [Indexed: 10/27/2022]
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Calculation of postoperative bone healing of cystic lesions of the jaw—a retrospective study. Clin Oral Investig 2019; 23:3951-3957. [DOI: 10.1007/s00784-019-02826-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 01/17/2019] [Indexed: 12/21/2022]
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Abstract
PURPOSE Recently, the terms sugosteogenesis and distraction sugosteogenesis have been introduced to the scientific literature. While the former describes a biologic phenomenon, the latter refers to the clinical technique which relies on the accelerated normal bone healing process that takes place at the osseous walls surrounding a cystic cavity when active negative pressure is applied. The purpose of this study is to provide the biologic bases and the therapeutic principles of this emerging technique. Employing well-stablished biologic principles, clinical evidence from analogous techniques, emerging experimental data, and circumstantial evidence, this study presents the possible mechanism of action of the evacuator for odontogenic cysts (Evocyst), a closed, vacuum-like drain system intended to treat cystic conditions using negative pressure. METHODS A review of the literature was done. Keywords for the Medline search were: marsupialization, decompression, odontogenic cysts, effects of negative pressure on bone, and negative pressure wound therapy. In addition, relevant publications from the reference list of the retrieved studies were considered. The matches were evaluated for relevance and analyzed accordingly. Clinical reports used to illustrate the concept of distraction sugosteogenesis were performed following the Declaration of Helsinki on medical protocol and ethics. RESULTS Currently, the standard of care to manage odontogenic cystic lesions includes marsupialization, enucleation and curettage, decompression, and surgical resection. However, there is a need for an alternative option in which the entity could be treated while promoting bone formation. With large odontogenic cystic conditions treated in a short period of time, distraction sugosteogenesis appears to be a choice. CONCLUSION The application of negative pressure to osseous cells produces a stretching that creates mechanical cues that trigger signaling pathways, promotes fluid flow, and enhances angiogenesis. All of them, combined, may explain sugosteogenesis. The clinical application of such parameters may explain the good clinical results obtained with the Evocyst.
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Marin S, Kirnbauer B, Rugani P, Mellacher A, Payer M, Jakse N. The effectiveness of decompression as initial treatment for jaw cysts: A 10-year retrospective study. Med Oral Patol Oral Cir Bucal 2019; 24:e47-e52. [PMID: 30573706 PMCID: PMC6344015 DOI: 10.4317/medoral.22526] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 11/16/2018] [Indexed: 11/22/2022] Open
Abstract
Background Decompression is an approved alternative to cystectomy in the treatment of jaw cysts. This study aimed to evaluate its effectiveness as an initial procedure, as well as factors with potential to influence outcome. Material and Methods The frequency of decompression was analysed, whether completed in one session or followed by enucleation at the Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, from 2005 to 2015. Further analysis focussed on factors potentially influencing outcome: cyst location, histopathology, means of preserving the cyst opening, cyst size, patient age. Results In all, 53 patients with 55 jaw cysts (mean age of 35.1) were treated by initial decompression in the ten-year period. In the majority of cases, histopathological analysis revealed a follicular cyst (43.6%), followed by odontogenic keratocysts (23.7%), radicular cysts (21.8%), residual cysts (7.3%) and nasopalatine cysts (3.6%) Treatment was completed with a single decompression in 45.5% of the cases. Among those, 72.0% were follicular cysts and 8.0% odontogenic keratocysts. Subsequent enucleation was needed in 54.5% of all cases, with a majority in the keratocystic group (36.7%). Histological findings, means of keeping the cyst open, and patient age were found to influence the effectiveness of decompression. Conclusions Decompression could be performed as a procedure completed in one session or combined with subsequent enucleation, mainly dependent on histopathological findings. Subsequent enucleation of odontogenic keratocysts is highly recommended. Key words:Jaw cysts, decompression, enucleation, histopathology, obturator.
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Affiliation(s)
- S Marin
- Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, Billrothgasse 4, A-8010 Graz, Austria,
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Jovanović M, Stojanović S, Todorović K, Obradović R, Igić M, Stojković B, Gligorijević N, Spasić M, Jovanović G. Early use of partial acrylic denture obturator in the postoperative treatment of bone defects after marsupialisation of large jaw cysts. ACTA STOMATOLOGICA NAISSI 2019. [DOI: 10.5937/asn1980970j] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Gao L, Ren W, Li S, Zheng J, Xue L, Xu Y, Wang Q, Song J, Dou Z, Zhou M, Xiao W, Zhi K. CBCT-based bone quality assessment in decompression of large odontogenic cystic lesions. Oral Radiol 2018; 34:251-256. [PMID: 30484038 DOI: 10.1007/s11282-018-0320-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 12/15/2017] [Indexed: 01/23/2023]
Abstract
OBJECTIVES Bone quality comprises bone mineral density and trabecular microstructure. The aim of this study was to explore the effectiveness of cone-beam computed tomography (CBCT) in evaluating bone quality of large odontogenic cystic lesions after decompression using CBCT and BoneJ software, and to determine whether secondary definitive surgery can be guided using CBCT data. METHODS Twenty-seven patients with large odontogenic cystic lesions treated by decompression were evaluated by CBCT. Medical history and perioperative details were analyzed. RESULTS The [Formula: see text]CT values for all patients with cystic lesions decreased after decompression, with no differences for age, sex, and histology (p > 0.05). Bone volume fraction and trabecular number of new cancellous bone (0.012%, 0.17/mm3) were lower than those of normal cancellous bone (0.189%, 0.47/mm3) (p < 0.05), while new cancellous bone trabecular separation (11.344 ± 2.556 mm) was stronger than normal cancellous bone trabecular separation (4.833 ± 2.232 mm) (p < 0.05). There were no differences in trabecular thickness between new cancellous bone (3.812 ± 1.593 mm) and normal cancellous bone (4.598 ± 3.573 mm) (p = 0.746). The [Formula: see text]CT values of five patients with favorable osteogenesis were - 72, -86, - 86, -47, and - 55, those of three patients with moderate osteogenesis were - 107, -120, and - 71, and those of two patients with poor osteogenesis were - 165 and - 127 during secondary definitive surgery. CONCLUSIONS CBCT is considered beneficial for evaluating bone quality of large odontogenic cystic lesions after decompression, while providing potentially useful information for referral to secondary definitive surgery.
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Affiliation(s)
- Ling Gao
- Department of Oral Maxillofacial Surgery, Key Laboratory of Oral Clinical Medicine, The Affiliated Hospital of Qingdao University, No. 1677, Wutaishan Road, Huangdao District, Qingdao, 266555, Shandong, China. .,Department of Implantology, The Affiliated Hospital of Qingdao University, Qingdao, 266555, Shandong, China. .,Department of Oral Maxillofacial Surgery, Stomatological Hospital, College of Medicine, Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China.
| | - Wenhao Ren
- Department of Oral Maxillofacial Surgery, Key Laboratory of Oral Clinical Medicine, The Affiliated Hospital of Qingdao University, No. 1677, Wutaishan Road, Huangdao District, Qingdao, 266555, Shandong, China.,Department of Implantology, The Affiliated Hospital of Qingdao University, Qingdao, 266555, Shandong, China.,Department of Oral Maxillofacial Surgery, Stomatological Hospital, College of Medicine, Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China
| | - Shaoming Li
- Department of Oral Maxillofacial Surgery, Key Laboratory of Oral Clinical Medicine, The Affiliated Hospital of Qingdao University, No. 1677, Wutaishan Road, Huangdao District, Qingdao, 266555, Shandong, China
| | - Jingjing Zheng
- Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao, 266555, Shandong, China.,Department of Oral Maxillofacial Surgery, Stomatological Hospital, College of Medicine, Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China
| | - Lingfa Xue
- Department of Oral Maxillofacial Surgery, Key Laboratory of Oral Clinical Medicine, The Affiliated Hospital of Qingdao University, No. 1677, Wutaishan Road, Huangdao District, Qingdao, 266555, Shandong, China
| | - Yaoxiang Xu
- Department of Oral Maxillofacial Surgery, Key Laboratory of Oral Clinical Medicine, The Affiliated Hospital of Qingdao University, No. 1677, Wutaishan Road, Huangdao District, Qingdao, 266555, Shandong, China
| | - Qibo Wang
- Department of Oral Maxillofacial Surgery, Key Laboratory of Oral Clinical Medicine, The Affiliated Hospital of Qingdao University, No. 1677, Wutaishan Road, Huangdao District, Qingdao, 266555, Shandong, China
| | - Jianzhong Song
- Department of Oral Maxillofacial Surgery, Key Laboratory of Oral Clinical Medicine, The Affiliated Hospital of Qingdao University, No. 1677, Wutaishan Road, Huangdao District, Qingdao, 266555, Shandong, China
| | - Zhichao Dou
- Department of Oral Maxillofacial Surgery, Key Laboratory of Oral Clinical Medicine, The Affiliated Hospital of Qingdao University, No. 1677, Wutaishan Road, Huangdao District, Qingdao, 266555, Shandong, China
| | - Minzhan Zhou
- Department of Oral Maxillofacial Surgery, Key Laboratory of Oral Clinical Medicine, The Affiliated Hospital of Qingdao University, No. 1677, Wutaishan Road, Huangdao District, Qingdao, 266555, Shandong, China
| | - Wenlin Xiao
- Department of Oral Maxillofacial Surgery, Key Laboratory of Oral Clinical Medicine, The Affiliated Hospital of Qingdao University, No. 1677, Wutaishan Road, Huangdao District, Qingdao, 266555, Shandong, China
| | - Keqian Zhi
- Department of Oral Maxillofacial Surgery, Key Laboratory of Oral Clinical Medicine, The Affiliated Hospital of Qingdao University, No. 1677, Wutaishan Road, Huangdao District, Qingdao, 266555, Shandong, China. .,Department of Implantology, The Affiliated Hospital of Qingdao University, Qingdao, 266555, Shandong, China. .,Department of Oral Maxillofacial Surgery, Stomatological Hospital, College of Medicine, Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China.
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Lizio G, Ferraioli L, Melini M, Marchetti C. Long-term investigation of decompression as a definitive treatment for mandibular cysts associated with impacted third molars. J Am Dent Assoc 2018; 149:953-959. [PMID: 30173817 DOI: 10.1016/j.adaj.2018.07.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 06/29/2018] [Accepted: 07/03/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND Clinicians sometimes use decompression for secondary, low-risk cyst enucleation. The authors explored whether the decompression of dentigerous cysts associated with third molars is a reliable, long-term, definitive treatment option. METHODS The authors monitored 25 mandibular cysts associated with impacted third molars in adults after surgical decompression without the extraction of the related tooth for a mean (standard deviation) time of 37 (15) months (range, 12-71 months). The authors carefully evaluated the postoperative clinical situation and the extent of radiographic shrinkage. RESULTS A minimal epithelial slit remained patent in all patients. All lacked clinical problems, had no need for further intervention, and exhibited persistent impaction of the teeth. The cyst reduction rate calculated on panoramic radiographs ranged from 63.4% to 98.8% (mean [standard deviation] 87.5% [10.6%]) and was statistically significant (P < .05). In 13 patients, the reduction rate was greater than 90%. CONCLUSIONS Decompression triggered marked radiographic reductions of cysts when epithelial communication persisted. The situation stabilized after the first 6 through 8 months, and no further intervention was required. PRACTICAL IMPLICATIONS It is risky to enucleate cysts associated with impacted third molars and extract the molars. Clinicians can solve the problem in dental practice by using surgical decompression.
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Abstract
PURPOSE OF REVIEW The management of benign, locally aggressive odontogenic tumors, namely, keratocystic odontogenic tumors (KOTs) and ameloblastomas, can be challenging. The purpose of this article is to briefly summarize important features of these lesions and review recent trends in the literature regarding their treatment. RECENT FINDINGS Currently, KOTs are frequently treated with a conservative approach consisting of enucleation and adjuvant decompression or local microablation with peripheral ostectomies, Carnoy's solution, or cryotherapy. Conversely, ameloblastomas generally require marginal or segmental resection followed by reconstruction using local bone regeneration techniques or vascularized osteocutaneous free flaps, respectively. Bone regeneration techniques have improved with the use of autogenous progenitor cells held in place by autogenous or alloplastic scaffolding. Esthetic results for free flap reconstruction have improved with the use of inconspicuous surgical approaches utilizing intraoral or rhytidectomy incisions. Molecular markers for both neoplasms are being investigated as potential targets for chemotherapeutic agents. SUMMARY Excluding hamartomas (i.e., odontomas), KOTs and ameloblastomas are the most common benign odontogenic lesions. Their management is often complicated by their locally infiltrative behavior, responsible for high rates of recurrence. Simple enucleation or excision of these lesions has proven insufficient. When left untreated, these lesions are capable of causing severe disfigurement and loss of function. Knowledge regarding current best practices and potential future therapeutics is imperative to well treated and effective disease management.
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Sun Y, Zhang J, Qian N, Sima G, Zhang J, Zhong J, Guo Z, Chen Y, Dong W. Comparison of the osteogenic differentiation of orofacial bone marrow stromal cells prior to and following marsupialization in patients with odontogenic cyst. Mol Med Rep 2017; 17:988-994. [PMID: 29115541 PMCID: PMC5780180 DOI: 10.3892/mmr.2017.7949] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Accepted: 10/18/2017] [Indexed: 12/26/2022] Open
Abstract
Decompression has been considered a valuable tool for odontogenic cystic lesions to minimize cyst size with low morbidity and recurrence. However, whether decompression has a role in regulating stem cell properties of orofacial bone marrow stromal cells (BMSCs) around the cysts has not been fully investigated. The present study compared the stem cell marker profile and osteogenic differentiation potential of orofacial BMSCs prior to and following marsupialization (pre-BMSCs vs. post-BMSCs) in the same individuals. The results demonstrated that post-BMSCs proliferated significantly faster, displayed higher colony-forming unit-fibroblast capacity and demonstrated higher expression of octamer binding protein 4, Nanog and SRY-related HMG box 2 when compared with the pre-BMSCs. Notably, the osteogenic potential was greater in the post-BMSCs compared with in pre-BMSCs, by demonstrating that the protein and mRNA expression levels of osteopontin, runt-related transcription factor 2, osteocalcin, alkaline phosphatase and osterix were upregulated in pre-BMSCs. Furthermore, the phosphorylated levels of extracellular signal-regulated kinase and c-Jun N-terminal kinase were enhanced in post-BMSCs. In conclusion, the study indicated that decompression influences the stem cell properties of orofacial BMSCs, and further studies are needed to verify the findings.
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Affiliation(s)
- Yao Sun
- Department of Stomatology, The First Hospital of Jiaxing, Jiaxing, Zhejiang 314000, P.R. China
| | - Juan Zhang
- Department of Stomatology, Zhenjiang Stomatological Hospital, Zhenjiang, Jiangsu 212000, P.R. China
| | - Naiying Qian
- Department of Stomatology, The First Hospital of Jiaxing, Jiaxing, Zhejiang 314000, P.R. China
| | - Guoqi Sima
- Department of Stomatology, The First Hospital of Jiaxing, Jiaxing, Zhejiang 314000, P.R. China
| | - Jianming Zhang
- Department of Stomatology, The First Hospital of Jiaxing, Jiaxing, Zhejiang 314000, P.R. China
| | - Jiayong Zhong
- Department of Stomatology, The First Hospital of Jiaxing, Jiaxing, Zhejiang 314000, P.R. China
| | - Zhiqin Guo
- Department of Stomatology, The First Hospital of Jiaxing, Jiaxing, Zhejiang 314000, P.R. China
| | - Yawen Chen
- Department of Stomatology, The First Hospital of Jiaxing, Jiaxing, Zhejiang 314000, P.R. China
| | - Weijie Dong
- Department of Stomatology, The First Hospital of Jiaxing, Jiaxing, Zhejiang 314000, P.R. China
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Oliveros-Lopez L, Fernandez-Olavarria A, Torres-Lagares D, Serrera-Figallo MA, Castillo-Oyagüe R, Segura-Egea JJ, Gutierrez-Perez JL. Reduction rate by decompression as a treatment of odontogenic cysts. Med Oral Patol Oral Cir Bucal 2017; 22:e643-e650. [PMID: 28809378 PMCID: PMC5694189 DOI: 10.4317/medoral.21916] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 06/15/2016] [Indexed: 12/17/2022] Open
Abstract
Background Odontogenic cysts are defined as those cysts that arise from odontogenic epithelium and occur in the tooth-bearing regions of the jaws. Cystectomy, marsupialization or decompression of odontogenic cyst are treatment approach to this pathology. The aim of this study was to evaluate the effectiveness of the decompression as the primary treatment of the cystic lesions of the jaws and them reduction rates involving different factors. Material and Methods 23 patients with odontogenic cysts of the jaws, previously diagnosed by anatomical histopathology (follicular cysts (7) and radicular cysts (16)) underwent decompression as an initial treatment. Clinical examination and pre and post panoramic radiograph were measured and analyzed. In addition, data as gender, age, time reduction and location of the lesion were collected. Results Significant results were obtained in relation to the location of lesions and the reduction rate (p<0.01). In a higher initial lesion, a greater reduction rate was observed (p<0.05). Conclusions Decompression as an initial treatment of cystic lesions of the jaws was effective; it reduces the size of the lesions avoiding a possible damage to adjacent structures. Cystic lesions in the mandible, regardless of the area where they occur will have a higher reduction rate if it is compared with the maxilla. Similar behavior was identified in large lesions compared to smaller. Key words:Decompression, reduction rate, cyst, maxilla, mandible.
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Affiliation(s)
- L Oliveros-Lopez
- School of Dentistry of Seville, C/ Avicena s/n 41009, Seville. Spain,
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Dentigerous cysts associated with impacted third molars in adults after decompression: a prospective survey of reduction in volume using computerised analysis of cone-beam computed tomographic images. Br J Oral Maxillofac Surg 2017; 55:691-696. [DOI: 10.1016/j.bjoms.2017.04.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 04/30/2017] [Indexed: 11/19/2022]
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Rodrigues JT, Dos Santos Antunes H, Armada L, Pires FR. Influence of surgical decompression on the expression of inflammatory and tissue repair biomarkers in periapical cysts. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 124:561-567. [PMID: 28822696 DOI: 10.1016/j.oooo.2017.06.121] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 06/21/2017] [Accepted: 06/22/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The biologic effects of surgical decompression on the epithelium and connective tissues of periapical cysts are not fully understood. The aim of this study was to evaluate the expression of tissue repair and inflammatory biomarkers in periapical cysts before and after surgical decompression. STUDY DESIGN Nine specimens of periapical cysts treated with decompression before undergoing complete enucleation were immunohistochemically analyzed to investigate the expression of interleukin-1β, tumor necrosis factor-α, transforming growth factor-β1, matrix metalloproteinase-9, Ki-67, and epidermal growth factor receptor. Expression of the biomarkers was classified as positive, focal, or negative. Ki-67 immunoexpression was calculated as a cell proliferation index. The expression of the biomarkers was compared in the specimens from decompression and from the final surgical procedure. RESULTS Computed tomography demonstrated that volume was reduced in all cysts after decompression. There were no differences in the immunoexpression of the proinflammatory and tissue repair biomarkers when comparing the specimens obtained before and after the decompression. CONCLUSIONS Surgical decompression was efficient in reducing the volume of periapical cysts before complete enucleation. When comparing the specimens obtained from surgical decompression and from complete surgical removal, the immunohistochemical analysis did not show a decrease in proinflammatory biomarkers; neither did it show an increase in tissue repair biomarkers.
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Affiliation(s)
| | | | - Luciana Armada
- Post-graduation Program in Dentistry, Estácio de Sá University, Rio de Janeiro, Brazil
| | - Fábio Ramôa Pires
- Post-graduation Program in Dentistry, Estácio de Sá University, Rio de Janeiro, Brazil.
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Peraza A, González L, González N. Outcome after 8 years of a modified conservative treatment experience in keratocystic odontogenic tumor in 5 patients. ORAL AND MAXILLOFACIAL SURGERY CASES 2017. [DOI: 10.1016/j.omsc.2017.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Alpy A, Tournaire L, Vaysse F, Marchal-Sixou C, Lhomme A, Courtois B. Intérêt de la décompression en orthodontie : à propos d’un cas de kératokyste chez l’enfant. Int Orthod 2017; 15:238-250. [PMID: 28460844 DOI: 10.1016/j.ortho.2017.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Alexandre Alpy
- Department of oral surgery, university of Toulouse, 31000 Toulouse, France.
| | | | - Fréderic Vaysse
- Department of oral surgery, university of Toulouse, 31000 Toulouse, France
| | | | - Arnaud Lhomme
- Department of oral surgery, university of Toulouse, 31000 Toulouse, France
| | - Bruno Courtois
- Department of oral surgery, university of Toulouse, 31000 Toulouse, France
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Alpy A, Tournaire L, Vaysse F, Marchal-Sixou C, Lhomme A, Courtois B. Interest of decompression in orthodontics: Case report of a keratocyst during childhood. Int Orthod 2017; 15:238-250. [PMID: 28460843 DOI: 10.1016/j.ortho.2017.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Keratocysts, also known as keratocystic odontogenic tumors (KCOT), make up 7% of all odontogenic cysts and develop asymptomatically in most cases. Enucleation is the benchmark treatment. However, there are surgical alternatives. Marsupialization and decompression are necessary in some cases, mainly when the KCOT is large, thus causing an increased risk of bone fracture, or if it has engulfed important elements such as the inferior alveolar nerve or teeth, consequently causing alveolar bone growth failure. The authors describe the case of a nine-year-old child treated for a large keratocyst situated in sector 4 (lower right jaw), impacting both premolars and the canine (45, 44 and 43). Surgical decompression associated with orthodontic multiband treatment were delivered to pull, and then place the three teeth in occlusion on the dental arch. With seven years hindsight since the first surgical procedure and three years since finishing orthodontic treatment, the cooperation between orthodontists and surgeons can be considered a success, from both the functional and esthetic points of view.
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Affiliation(s)
- Alexandre Alpy
- Department of oral surgery, university of Toulouse, 31000 Toulouse, France.
| | | | - Fréderic Vaysse
- Department of oral surgery, university of Toulouse, 31000 Toulouse, France
| | | | - Arnaud Lhomme
- Department of oral surgery, university of Toulouse, 31000 Toulouse, France
| | - Bruno Courtois
- Department of oral surgery, university of Toulouse, 31000 Toulouse, France
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Asutay F, Atalay Y, Turamanlar O, Horata E, Burdurlu MÇ. Three-Dimensional Volumetric Assessment of the Effect of Decompression on Large Mandibular Odontogenic Cystic Lesions. J Oral Maxillofac Surg 2016; 74:1159-66. [DOI: 10.1016/j.joms.2015.12.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 11/26/2015] [Accepted: 12/14/2015] [Indexed: 11/25/2022]
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Brajić I, Škodrić S, Milenković S, Tepavčević Z, Soldatović I, Čolić S, Milašin J, Andrić M. Survivin, cyclin D1, and p21hras in keratocystic odontogenic tumors before and after decompression. Oral Dis 2016; 22:220-5. [DOI: 10.1111/odi.12414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 11/17/2015] [Accepted: 11/26/2015] [Indexed: 11/29/2022]
Affiliation(s)
- I Brajić
- Department of Oral Surgery; School of Dental Medicine; University of Belgrade; Belgrade Serbia
| | - S Škodrić
- Department of Pathology; School of Medicine; University of Belgrade; Belgrade Serbia
| | - S Milenković
- Department of Pathology; Clinical Hospital Center; Zemun Serbia
| | - Z Tepavčević
- Department of Pathology; School of Dental Medicine; University of Belgrade; Belgrade Serbia
| | - I Soldatović
- School of Medicine; University of Belgrade; Belgrade Serbia
| | - S Čolić
- Department of Oral Surgery; School of Dental Medicine; University of Belgrade; Belgrade Serbia
| | - J Milašin
- Department of Molecular Genetics; School of Dental Medicine; University of Belgrade; Belgrade Serbia
| | - M Andrić
- Department of Oral Surgery; School of Dental Medicine; University of Belgrade; Belgrade Serbia
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Song I, Park H, Seo B, Lee J, Kim M. Effect of decompression on cystic lesions of the mandible: 3-dimensional volumetric analysis. Br J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.bjoms.2015.06.024] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Castro-Núñez J. Decompression of Odontogenic Cystic Lesions: Past, Present, and Future. J Oral Maxillofac Surg 2015; 74:104.e1-9. [PMID: 26428611 DOI: 10.1016/j.joms.2015.09.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 09/01/2015] [Indexed: 11/18/2022]
Abstract
Tumors and cystic lesions of the jawbones have been described since the late 1600s and it took another 200 years for classification systems to appear in the medical, surgical, and dental literatures. In the late 1800s, Carl Partsch introduced cystostomy, a method by which the cyst is converted into a pouch by suturing its lining to the mucosa of the oral cavity. The purpose of this article is to analyze the history, present, and future of cystic conditions of the jaws and decompression, a modality of treatment that during the past few years has regained the attention of oral and maxillofacial surgeons and pathologists owing to its relative simplicity and effectiveness compared with other conservative options.
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Affiliation(s)
- Jaime Castro-Núñez
- Researcher, Research Department, Institución Universitaria Colegios de Colombia, Colegio Odontológico, Bogotá, Colombia; Oral and Maxillofacial Surgeon, Clínica Nueva, Bogotá, Colombia; Oral Pathologist, Universidad El Bosque School of Dentistry, Bogotá, Colombia; and Visiting Professor, Universidad Evangélica de El Salvador School of Dentistry, San Salvador, El Salvador.
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Batra J, Attresh G, Garg B, Goel M. Decompression as a Treatment of Odontogenic Cystic Lesions in Children. J Oral Maxillofac Surg 2015; 73:1667. [PMID: 26067558 DOI: 10.1016/j.joms.2015.04.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 04/26/2015] [Indexed: 11/24/2022]
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Allon DM, Allon I. Reply: To PMID 25631867. J Oral Maxillofac Surg 2015; 73:1667-8. [PMID: 26037131 DOI: 10.1016/j.joms.2015.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Accepted: 05/11/2015] [Indexed: 11/24/2022]
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Allon DM, Allon I, Anavi Y, Kaplan I, Chaushu G. Decompression as a Treatment of Odontogenic Cystic Lesions in Children. J Oral Maxillofac Surg 2015; 73:649-54. [DOI: 10.1016/j.joms.2014.10.024] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 10/18/2014] [Accepted: 10/20/2014] [Indexed: 10/24/2022]
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Park HS, Song IS, Seo BM, Lee JH, Kim MJ. The effectiveness of decompression for patients with dentigerous cysts, keratocystic odontogenic tumors, and unicystic ameloblastoma. J Korean Assoc Oral Maxillofac Surg 2014; 40:260-5. [PMID: 25551089 PMCID: PMC4279975 DOI: 10.5125/jkaoms.2014.40.6.260] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 11/03/2014] [Accepted: 11/07/2014] [Indexed: 12/05/2022] Open
Abstract
Objectives The aim of this study was to verify the clinical effectiveness of decompression in decreasing the size of a cyst. In addition to the different types of cysts, we tried to reveal what effect host factors, such as the initial size of the lesion and the age of the patient, have on the velocity of cyst shrinkage. Materials and Methods With the aid of a panoramic view, we measured the size of the cysts before and after decompression in 13 dentigerous cysts (DCs), 14 keratocystic odontogenic tumors (KTOCs), and 5 unicystic ameloblastoma (UA) cases. The velocity of shrinkage in the three cystic groups was calculated. Relationships between the age of the patient, the initial size of the cyst, and the shrinkage velocity were investigated. Results The three types of cysts showed no inter-type differences in their velocity of shrinkage. However, there was a statistically meaningful relationship between the initial size of the lesion and the absolute velocity of shrinkage in the DC group (P=0.02, R=0.65) and the KTOC group (P=0.02, R=0.56). There was also a significant relationship between the age of the patient and the absolute velocity of shrinkage in the KTOC group (P=0.04, R=0.45) and the UA group (P=0.04, R=0.46). Conclusion There was no difference in the decrease in size due to decompression among the different types of cysts. However, the age of the patient and the initial size of the lesion showed a significant relationship with the velocity of shrinkage.
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Affiliation(s)
- Hyun-Soo Park
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, Seoul National University Dental Hospital, Seoul, Korea
| | - In-Seok Song
- Department of Oral and Maxillofacial Surgery, Korea University Anam Hospital, Seoul, Korea
| | - Byoung-Moo Seo
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, Seoul National University Dental Hospital, Seoul, Korea
| | - Jong-Ho Lee
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, Seoul National University Dental Hospital, Seoul, Korea
| | - Myung-Jin Kim
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, Seoul National University Dental Hospital, Seoul, Korea
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Jung EJ, Baek JA, Leem DH. Decompression Device Using a Stainless Steel Tube and Wire for Treatment of Odontogenic Cystic Lesions: A Technical Report. Maxillofac Plast Reconstr Surg 2014; 36:308-10. [PMID: 27489852 PMCID: PMC4283540 DOI: 10.14402/jkamprs.2014.36.6.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Revised: 09/16/2014] [Accepted: 10/15/2014] [Indexed: 11/17/2022] Open
Abstract
Decompression is considered an effective treatment for odontogenic cystic lesions in the jaw. A variety of decompression devices are successfully used for the treatment of keratocystic odontogenic tumors, radicular cysts, dentigerous cysts, and ameloblastoma. The purpose of these devices is to keep an opening between the cystic lesion and the oral environment during treatment. The aim of this report is to describe an effective decompression tube using a stainless steel tube and wire for treatment of jaw cystic lesions.
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Affiliation(s)
- Eun-Joo Jung
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonbuk National University
| | - Jin-A Baek
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonbuk National University; Research Institute of Clinical Medicine, Chonbuk National University
| | - Dae-Ho Leem
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonbuk National University; Research Institute of Clinical Medicine, Chonbuk National University
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Letters to the editor. J Oral Maxillofac Surg 2014; 72:1231-2. [PMID: 24947963 DOI: 10.1016/j.joms.2014.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 04/03/2014] [Indexed: 11/23/2022]
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47
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Decompression as a treatment for odontogenic cystic lesions of the jaw. J Oral Maxillofac Surg 2014; 72:1231. [PMID: 24947962 DOI: 10.1016/j.joms.2014.03.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 03/06/2014] [Indexed: 11/22/2022]
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