Decompression of Large Cyst Invading the Mandibular Canal Leading to Reduced Cyst Volume and Increased Mandibular Canal Length

Cho, Jin-Yong; Kim, Jin-Woo; Kim, Sung-beom; Ryu, Jaeyoung

doi:10.1016/j.joms.2020.05.025

Cited by 8 publications

(4 citation statements)

References 19 publications

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“…Our conservative, two-staged surgery, consisting of initial marsupialization with simultaneous diagnosis, followed by radical resection and reconstruction of the defect with a titanium mesh implant, provided an optimal therapeutic approach for an otherwise aggressively growing lesion with almost complete mandibular resorption. Decompression of the cysts has been long documented with beneficial effects on bone regeneration [23][24][25]. In our case, within three months, the dimensions of the lesion have reduced by more than 50%, and significant bone regeneration could be evidenced through imagistic assessment, with new bone apposition within the cystic walls, ranging between 1-5 mm of new bony tissue.…”

Section: Discussionmentioning

confidence: 49%

Minimally Invasive Two-Staged Surgery in the Treatment of Large Cystic Lesions of the Jaw

Irimia¹,

Moraru

Ciubotaru

et al. 2021

Healthcare

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Background: Cystic lesions of the jaw are commonly found in clinical practice. Large, expansive cysts raise challenges for the clinician from both diagnostic and surgical perspectives. The aim of our work is to present a combined, two-staged surgical approach in histologically confirmed non-aggressive cystic lesions of the jaw. Methods and Results: We report the case of an extensive mandibular cyst, associating a high risk of bone fracture, that is treated in the initial stage by cystic decompression through marsupialization with concomitant histological diagnostic confirmation, followed in the second stage by radical excision and mandibular reconstruction with titanium mesh, with the purpose of prevention for oro-cystic chronic fistula formation. Conclusions: Large odontogenic mandibular cysts imply a meticulously conducted assessment and treatment. Marsupialization should be taken into consideration for the treatment of large cystic lesions, followed by secondary enucleation, with minimal risks for the patient. The soft tissue healing process can be optimized with the use of titanium meshes, as an alternative for other reconstructive techniques, in the management of large cystic lesions.

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Section: Discussionmentioning

confidence: 49%

Minimally Invasive Two-Staged Surgery in the Treatment of Large Cystic Lesions of the Jaw

Irimia¹,

Moraru

Ciubotaru

et al. 2021

Healthcare

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“…The causal relationship between the eruption disturbance of a PM1 and the deviation of mandibular canal could not be clarified in this study. On the basis of a similar study, it may be reasonable to consider the positional change of the mandibular canal as a result [22]. If the deviated mandibular canal was the result from the eruption disturbance of a PM1, it implies that the eruption disturbances of PM1s can affect to the growth and development of the mandible and also the rear part of the PM1s.…”

Section: Discussionmentioning

confidence: 99%

“…Other studies have performed radiographic evaluations of the mandibular canal at the level of the mandibular first molars; however, these studies were performed exclusively in patients with mature and normally erupted mandibular first molars [18][19][20][21]. More recently, it has been reported that mandibular cysts can affect the length and position of the mandibular canal [22]. To our knowledge, however, there have been no previous studies examining the position of the mandibular canal in relation to PM1s with eruption disturbances in children.…”

Section: Introductionmentioning

confidence: 99%

Positional Differences of the Mandibular Canal in Relation to Permanent Mandibular First Molars with Eruption Disturbances in Children

2020

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Eruption disturbances in permanent mandibular first molars (PM1s) are uncommon. This retrospective study aimed to investigate differences in the position of the mandibular canal in relation to PM1s, with or without, eruption disturbances. Panoramic and cross-sectional views were reconstructed from cone-beam computed tomography imaging of children with PM1 eruption disturbances. Distances from the most inferior margin of the mandible to the center of the mandibular canal (M–C) and from the outer margin of the lingual cortex to the center of the mandibular canal (L–C) were measured for normally erupted PM1s (normal group) and for PM1s with eruption disturbances (ED group) and compared using independent t-tests. The mean M–C was significantly shorter in the ED group (4.86 ± 1.07 mm) than in the normal group (6.56 ± 1.06 mm) (p < 0.05). The mean L–C was also significantly shorter in the ED group (2.74 ± 0.74 mm) than in the normal group (3.09 ± 0.71 mm) (p < 0.05). This study demonstrated that the mandibular canal tended to be positioned more inferiorly in relation to PM1s with eruption disturbances than normally erupted PM1s in children. Clinicians should be aware of this positional deviation when managing children with PM1 eruption disturbances.

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“…Decompression may be a better initial option in large size lesions as enucleation may potentially harm nearby anatomical structures, or fracture of the mandible. Surgeons can opt for a combination of decompression followed by enucleation to reduce recurrence rate (5) . Marsupialization is a surgical procedure in which a window is made in the cyst wall to release intracystic pressure, allowing the bony cavity to gradually shrink in size and volume.…”

Section: Introductionmentioning

confidence: 99%

Optimum time of enucleation following marsupialization as a treatment strategy for large odontogenic keratocyst. (Radiologic and histopathologic study)

Esmael

Aly

kammar

et al. 2023

Egyptian Dental Journal

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Objectives:The aim of the current study was to estimate change of cyst volume after marsupialization, evaluate bone formation and to determine the optimum time for enucleation.Patients and methods: A total of 21 patients suffering from large odontogenic keratocyst more than 3cm in its largest diameter were treated by marsupialization followed by enucleation. The inferior alveolar nerve length and affection, as well as the overall and percentage cyst volume reduction, were the primary outcome factors. Postoperative follow-up consisted of clinical and radiographic examinations 3 months, 6 and 9 months after marsupialization.Results: Healing was uneventful in all patients, at three months, six months, and nine months postoperatively, the cyst volume had decreased by 39.05%, 65.62%, and 82.67%, respectively. The first three months showed a greater increase in bone density and decrease in cysts volume than the following three months (P < .01). The total number of patients underwent marsupialization for an average of 280 days. Up to nine months after surgery, none of the patients had an OKC recurrence. Conclusion:Within the limitations of our study, the enucleation timing after marsupialization of OKC is determined by the decrease of cyst volume and increase of its density and showed relocation of the inferior alveolar neurovascular bundle. Nonetheless, additional research is required with a larger study population and a longer follow-up period.

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Decompression of Large Cyst Invading the Mandibular Canal Leading to Reduced Cyst Volume and Increased Mandibular Canal Length

Cited by 8 publications

References 19 publications

Minimally Invasive Two-Staged Surgery in the Treatment of Large Cystic Lesions of the Jaw

Minimally Invasive Two-Staged Surgery in the Treatment of Large Cystic Lesions of the Jaw

Positional Differences of the Mandibular Canal in Relation to Permanent Mandibular First Molars with Eruption Disturbances in Children

Optimum time of enucleation following marsupialization as a treatment strategy for large odontogenic keratocyst. (Radiologic and histopathologic study)

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