OBJECTIVES: This study aims to evaluate the changes in the mandibular canal following the treatment of large odontogenic keratocysts through decompression and curettage, providing a theoretical basis for sequential treatment. METHODS: Twenty patients were selected for each decompression and curettage treatment of large odontogenic keratocysts in the mandible. Postoperative follow-up with was conducted every three months, during which cone beam computed tomography (CBCT) scans were performed. Then, the data were imported into MIMICS software to observe 3D changes in the position and structure of the mandibular nerve canal, followed by a comparative analysis. RESULTS: The total displacement of the mandibular canal was (1.89±0.21) mm on the decompression side and (0.80±0.19) mm on the curettage side. Vertically, the displacement range of the mandibular canal on the decompression side (M=1.03, SD=0.17) was larger than on the curettage side (M=0.52, SD=0.010) within nine months post-operation. In the buccal-lingual direction, the ratio of the thickness of the buccal plate to the lingual plate gradually increased with time. The amount of bone reconstruction at the part of the mandibular nerve canal closest to the cyst was (1.75±0.15) mm on the decompression side and (1.45±0.09) mm on the curettage side after nine months. CONCLUSIONS The mandibular nerve canal showed varying degrees of recovery and "relocation" after two surgical procedures. Osteogenesis around the mandibular nerve canal was more remarkable after decompression than after curettage. Therefore, for large odontogenic keratocyst, decompression is recommended as the initial treatment, followed by secondary curettage nine months later.
Humans ; Odontogenic Cysts/diagnostic imaging* ; Retrospective Studies ; Cone-Beam Computed Tomography ; Decompression, Surgical/methods* ; Mandibular Nerve/surgery* ; Mandible/innervation* ; Curettage ; Male ; Female ; Adult ; Middle Aged

Pathological fractures after jaw cyst surgery are rare clinically but are a serious complication. Once a pathological fracture occurs, treatment time and economic costs increase, and doctors face difficulty in handling it. This article reports a case of a patient with mandibular pathological fractures after multiple odontogenic keratocyst surgery of the jaw. Mandibular lesions were located in the bilateral mandibular angles and had macrocystic changes. We adopted a conservative treatment plan, and the treatment effect was good. We also discussed and analyzed relevant literature to provide a reference for clinicians.
Humans ; Odontogenic Cysts/surgery* ; Conservative Treatment ; Postoperative Complications/therapy* ; Mandibular Fractures/etiology* ; Fractures, Spontaneous/etiology* ; Male ; Female

Objective:To investigate the feasibility and clinical effect of the surgical approach and method of transnasal fenestration under nasal endoscope for the treatment of maxillary odontogenic cyst. Methods:The clinical data of 23 cases with maxillary odontogenic cysts treated by nasal endoscopy through nasal fenestration were retrospectively analyzed. All cases underwent nasal endoscopy and CT examination before the operation. The mucosal membrane of the parietal wall of the cyst was excised through fenestration of the nasal base. The cyst fluid was removed by decompression, and the bony opening of the nasal base was trimmed and enlarged to the edge of the cyst. The intraoperative and postoperative effects were observed. Results:All cases were well exposed under the direct vision of nasal endoscope. The top wall of the cyst was removed to maximize the communication between the cyst cavity and the nasal floor. There were no complications such as nasolacrimal duct injury, turbinate atrophy, necrosis, and facial numbness. All patients were followed up for 6-12 months, and the clinical symptoms gradually disappeared after surgery. The inferior turbinate was in good shape, the cyst cavity was smooth, the cyst wall was determined, and no cyst recurrence was observed. Conclusion:The treatment of odontogenic cyst of maxilla under nasal endoscope through nasal fenestration is convenient. It has less trauma, fewer complications and a satisfactory curative effect, which is worthy of clinical promotion.
Humans ; Maxilla ; Retrospective Studies ; Odontogenic Cysts/surgery* ; Endoscopy ; Turbinates/surgery* ; Endoscopes

OBJECTIVES: This study aimed to determine the prevalence of odontogenic cysts, tumors, and other lesions among reports in the archives of the Department of Oral and Maxillofacial Surgery at the Faculty of Dentistry affiliated with Kocaeli University collected over a four-year period.MATERIALS AND METHODS: In this retrospective study, patient records from the archive of the Department of Oral and Maxillofacial Surgery from 2014 to 2018 were reviewed. Patient demographic information (age and sex) and lesion location were recorded and analyzed.RESULTS: From a total of 475 files reviewed, odontogenic cyst was confirmed in 340 cases (71.6%), and odontogenic tumor was confirmed in 52 cases (10.9%). Regarding odontogenic cyst type, the most common was radicular cyst (216 cases), followed by dentigerous cyst (77 cases) and odontogenic keratocyst (23 cases). Among odontogenic tumors, the most frequent was odontoma (19 cases), followed by ossifying fibroma (18 cases) and ameloblastoma (9 cases). Giant cell granuloma was also reported in 35 cases.CONCLUSION: The distribution pattern of odontogenic cysts and tumors in our retrospective study is relatively similar to that reported in the literature. Complete clinical reports for final diagnosis of these lesions and routine follow-up examinations are very important for treatment.
Ameloblastoma ; Archives ; Biopsy ; Dentigerous Cyst ; Dentistry ; Diagnosis ; Fibroma, Ossifying ; Follow-Up Studies ; Granuloma, Giant Cell ; Humans ; Jaw Neoplasms ; Odontogenic Cysts ; Odontogenic Tumors ; Odontoma ; Prevalence ; Radicular Cyst ; Retrospective Studies ; Surgery, Oral

cysts in the oral and maxillofacial regions.METHODS: A retrospective observational study was conducted on 164 patients who had been diagnosed with cyst of the jaw, from the database of 168 histopathological diagnoses at the Department of Oral and Maxillofacial Surgery of Busan Paik Hospital at Inje University, from January 2009 to December 2011. The subjects were treated and the following variables were recorded: gender, age, clinical signs and symptoms, histopathological distribution, treatment methods, and complications. A descriptive analysis of the study variables was performed using a chi-square test.RESULTS: Among the 164 patients, there were more male than female patients (male-female ratio: 1.7:1). The most predominant ages were the 20s and 40s. Among the classes of pathological cysts, radicular cysts and dentigerous cysts were the most common, with incidences of 56.0% and 35.1%. Thirty-six percent of the patients had no symptoms; and of those who had symptoms, the main signs and symptoms were swelling (24.4%) and pain (17.1%). The most frequent management method was the combination operation, such as enucleation with or without extraction and apicoectomy of the causative teeth. Of the 164 patients, 13 had complications; and one patient who had been treated with enucleation with apicoectomy had a recurrent cyst.CONCLUSION: Using a chi-square test, no significant differences in prevalence were observed in relation to gender according to age. Comparative analysis of radicular and dentigerous cysts showed a significant difference in their prevalence according to their anatomical location, however, no significant differences in were observed in their incidence rates according to age.]]>
Apicoectomy ; Busan ; Classification ; Dentigerous Cyst ; Diagnosis ; Female ; Humans ; Incidence ; Jaw ; Male ; Methods ; Observational Study ; Odontogenic Cysts ; Prevalence ; Radicular Cyst ; Retrospective Studies ; Surgery, Oral ; Tooth

OBJECTIVETo evaluate the effect of fenestration and suction drainage in the treatment of large odontogenic mandibular cystic lesions.

METHODSFrom 2005 to 2009, 24 cases of large odontogenic mandibular cystic lesions were treated with fenestration and suction drainage. The clinical symptoms and radiographical findings were evaluated before the operation and at 1 month and 6 months after suction drainage.

RESULTSFollow-up for 1-3 years showed that all the cystic lesions disappeared without recurrence, and the clinical symptoms were resolved.

CONCLUSIONFenestration and suction drainage can reduce the cystic size and rapidly correct the deformity to serve as a useful modality for primary management of large odontogenic mandibular cystic lesions.

Adolescent ; Adult ; Female ; Follow-Up Studies ; Humans ; Male ; Mandibular Diseases ; surgery ; Middle Aged ; Odontogenic Cysts ; surgery ; Suction ; methods ; Young Adult

The odontogenic keratocyst (OKC) was originally classified as a developmental cyst, and OKCs were histologically divided into orthokeratotic (O-OKCs) and parakeratotic (P-OKCs) types. Clinical features differ between O-OKCs and P-OKCs with P-OKCs having a tendency to recur after surgical treatment. According to the revised histopathological classification of odontogenic tumors by the World Health Organization (2005) , the term keratocystic odontogenic tumor (KCOT) has been adopted to describe P-OKCs. In this retrospective study, we examined 186 KCOTs treated at the Maxillofacial Surgery Department of the Tokyo Medical and Dental University Hospital from 1981 through 2005. The patients ranged in age from 7 to 85 years (mean, 32.7) and consisted of 93 males and 93 females. The most frequently treated areas were the mandibular molar region and ramus. The majority of KCOTs in the maxillary region were treated by enucleation and primary closure. The majority of KCOTs in the mandibular region were enucleated, and the wound was left open. Marginal resection was performed in the 4 patients with large lesions arising in the mandible. In patients who were followed for more than a year, recurrences were observed in 19 of 120 lesions (15.8%) . The recurrences were found at the margins of the primary lesion in contact with the roots of the teeth or at the upper margins of the mandibular ramus. Clinicians should consider aggressive treatment for KCOTs because the recurrence rate of P-OKCs is higher than that of other cyst types such as O-OKCs, dentigerous cysts, primordial cysts that were non-keratinized, and slightly keratinized stratified squamous epithelium. Although more aggressive treatment is needed for KCOTs as compared to other cystic lesions, it is difficult to make a precise diagnosis preoperatively on the basis of clinical features and X-ray imaging. Therefore, preoperative biopsy is necessary for selecting the appropriate treatment for patients with cystic lesions.
Biopsy ; Dentigerous Cyst ; Epithelium ; Female ; Humans ; Keratins ; Male ; Mandible ; Molar ; Odontogenic Cysts ; Odontogenic Tumors ; Recurrence ; Retrospective Studies ; Surgery, Oral ; Tokyo ; Tooth ; World Health Organization

INTRODUCTION: Bone defects in the jaw are frequently observed after odontogenic cyst enucleation. The success of bone healing appears to be related to the size of the bone defect, the anatomical location, the patient's age and other parameters. The use of bone grafting material is dependent on the operator's preference. No evidence-based definite treatment protocol has been established. This study evaluated the effect of a bone graft into the defect after odontogenic cyst enucleation. MATERIALS AND METHODS: A total of 55 patients, who had been treated for an odontogenic cyst with cyst enucleation from 2000 to 2009 at the department of Oral and Maxillofacial Surgery, Samsung Medical Center, were included in this study. Patients who were followed-up for more than 1 year were included. Two groups were defined according to the bone graft (with or without a bone graft) after cyst enucleation. The differences in the healing periods and patterns of bone healing were compared clinically and radiologically. The postoperative 1 year radiographs were analyzed for bone healing and density. Statistical analysis was performed using a Pearson chi square test and Wilcoxon rank-sum test. RESULTS: More infection signs were observed in the bone graft group than in the other group, but there was no statistically significant difference. Radiographically, there was also no significant difference in the size of the radiolucent lesions between the two groups. CONCLUSION: There was no significant difference in healing between the groups with a bone graft and without bone graft after cyst enucleation.
Bone Transplantation ; Clinical Protocols ; Humans ; Jaw ; Odontogenic Cysts ; Surgery, Oral ; Transplants

PURPOSE: The purpose of this study is to investigate the clinical and histological features of odontogenic keratocyst PATIENTS AND METHODS: A retrosective review of 100 patients who were diagnosed as odontogenic keratocyst by hitological findings during the period of January 2000 and December 2005 in the Dept. of Oral and Maxillofacial surgery Pusan National University was consecuted. For each patient, age, sex, location of lesion, initial diagnosis by radiographic features, treatment procedure, hitologic findings and recurrance rate were evaluated. RESULTS: In this study, OKC has male prevalance to female by 1.38:1, and most likely occurs during third decade. The most common site of lesion was mandibular ramus region(34.6%) and the most common symptom was swelling(50%). The most common initial diagnosis by radiographic findings was OKC and cyst enucleation was the most common treatment method. The recurrance rate was 28% and existence of daugther cyst is thought to be most convincing factor for prediction of recurrence. CONCLUSION: In this study, total recurrence rate was 28% and existence of daugther cyst is thought to be most convincing factor for prediction of recurrence. But, since 97% of patients were treated by enucleation and adjuntive excision, further styudy is need about concordance of recurrence rate with surgical method.
Female ; Humans ; Male ; Odontogenic Cysts ; Recurrence ; Surgery, Oral

odontogenic keratocyst in the department of Oral and maxillofacial Surgery of Kyungpook National University from 2006 to 2008, and following results were obtained. 1. Among 52 cases of OKCs, all cases were parakeratinzied. 2. Among 52 cases of OKCs, 42 cases were type I, 9 cases were type II and 1 case was type V. 3. Among 52 cases of OKCs, there were bud-like proliferation of basal cell layer on connective tissue area on 10 cases, satellite cysts on overlying oral mucosa or connective tissue area on 6 cases and rests of epithelium on connective tissue area on 6 cases. 4. Among 52 cases of OKCs, there were focal inflammation on the epithelium of the OKCs on 6 cases and diffuse inflammation on 8 cases. 5. Among 52 cases of OKCs, cytokeratin-10 was expressioned on superfical and intermediate layer on all cases. Accordingly, the presence or absence of cytokeration-10 on the epithelium of the cyst will be good differential diagnosis of between OKC and dentigerous cyst.]]>
Connective Tissue ; Dentigerous Cyst ; Diagnosis, Differential ; Epithelium ; Humans ; Immunohistochemistry ; Inflammation ; Mouth Mucosa ; Odontogenic Cysts ; Surgery, Oral