Case Report
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Conservative approach for the treatment of odontogenic cysts: Report of two cases

Year 2021, Volume: 8 Issue: 2, 561 - 565, 31.08.2021
https://doi.org/10.15311/selcukdentj.550819

Abstract

Backround: Odontogenic keratocyst is the most aggressive cyst that develops from
dental lamina remnants. It recurrence and infiltrate to tissues. Dentigerous
cyst is the second most common cyst and often does not cause symptoms. In this
case report, marsupialization of these two cysts with large settlement is
presented. 

Case Report: In both cases, after clinical and radiological
examination, a large radiolucent lesion was determined at the mandibula,
without pain, intraoral and extraoral expansions. Under local anesthesia, full
thickness flap was raised and the cavity was opened in the bone. The cyst fluid
was evacuated. Then, the gas iodoform sutured to maintain cavity gap. 

Conclusions: Odontogenic keratocyst and dentigerous cyst are
mostly lesions have seen in the posterior region of the mandible and reaching
large sizes. Enucleation and marsupialisation can be performed according to the
size of the lesion in treatment. Patients should be followed for a long time
with postoperative histopathological examination.

Keywords: Keratocyst,
dentigerous cyst, marsupialization

References

  • 1. Partsch C. Uber kiefercysten. Deutsche Monatsschrift Fur Zahnheilkunde 10, 271, Quoted from Pogrel, MA, 2005. Treatment of keratocysts: The case for decompression and marsupialization. J Oral Maxillofac Surg. 1892;63:1667-1673.
  • 2. Tolstunov L. Marsupialization catheter. Journal of Oral and Maxillofacial Surgery. 2008;66(5):1077-1079.
  • 3. Pogrel MA. Treatment of keratocysts: The case for decompression and marsupialization. Journal of oral and maxillofacial surgery. 2005;63(11):1667-1673.
  • 4. Sun R, Cai Y, Wu Y, et al. Marsupialization facilitates movement of the cystic lesion-associated deeply impacted mandibular third molar in spite of its mature roots. Medicina oral, patologia oral y cirugia bucal. 2017;22(5):e625.
  • 5. Gao L, Wang X-L, Li S-M, et al. Decompression as a treatment for odontogenic cystic lesions of the jaw. Journal of Oral and Maxillofacial Surgery. 2014;72(2):327-333.
  • 6. Ghandour L, Bahmad HF, Bou-Assi S. Conservative Treatment of Dentigerous Cyst by Marsupialization in a Young Female Patient: A Case Report and Review of the Literature. Case reports in dentistry. 2018;2018.
  • 7. Al-Moraissi EA, Pogrel MA, Ellis III E. Enucleation with or without adjuvant therapy versus marsupialization with or without secondary enucleation in the treatment of keratocystic odontogenic tumors: A systematic review and meta-analysis. Journal of Cranio-Maxillofacial Surgery. 2016;44(9):1395-1403.
  • 8. Wushou A, Zhao Y-J, Shao Z-M. Marsupialization is the optimal treatment approach for keratocystic odontogenic tumour. Journal Of Cranio-Maxillofacial Surgery. 2014;42(7):1540-1544.
  • 9. Borghesi A, Nardi C, Giannitto C, et al. Odontogenic keratocyst: imaging features of a benign lesion with an aggressive behaviour. Insights Imaging. 2018.
  • 10. Madras J, Lapointe H. Keratocystic odontogenic tumour: reclassification of the odontogenic keratocyst from cyst to tumour. Tex Dent J. 2008;125(5):446-454.
  • 11. Pogrel MA. Decompression and marsupialization as a treatment for the odontogenic keratocyst. Oral and Maxillofacial Surgery Clinics. 2003;15(3):415-427.
  • 12. Ertas Ü, Yavuz MS. Interesting eruption of 4 teeth associated with a large dentigerous cyst in mandible by only marsupialization. Journal of oral and maxillofacial surgery. 2003;61(6):728-730.
  • 13. Martínez-Pérez D, Varela-Morales M. Conservative treatment of dentigerous cysts in children: a report of 4 cases. Journal of oral and maxillofacial surgery. 2001;59(3):331-333.
  • 14. Fujii R, Kawakami M, Hyomoto M, et al. Panoramic findings for predicting eruption of mandibular premolars associated with dentigerous cyst after marsupialization. Journal of Oral and Maxillofacial Surgery. 2008;66(2):272-276.
  • 15. Nishide N, Hitomi G, Miyoshi N. Irrigational therapy of a dentigerous cyst in a geriatric patient: a case report. Special Care in Dentistry. 2003;23(2):70-72.
  • 16. Warburton G, Shihabi A, Ord RA. Keratocystic odontogenic tumor (KCOT/OKC)—Clinical guidelines for resection. Journal of maxillofacial and oral surgery. 2015;14(3):558-564.
  • 17. Mejia JL, Donado JE, Basrani B. Active nonsurgical decompression of large periapical lesions–3 case reports. J Can Dent Assoc. 2004;70(10):691-694.
  • 18. Bouquot JE. Odontogenic cysts and tumors. In: Neville BW, Damm DD, Allen CM,eds Oral and Maxillofacial Pathology 2nd ed Philadelphia: WB Saunders. 2002:683-687.

Büyük boyutlara ulaşmış odontojenik kistlerin tedavisinde konservatif yaklaşım: İki olgu sunumu

Year 2021, Volume: 8 Issue: 2, 561 - 565, 31.08.2021
https://doi.org/10.15311/selcukdentj.550819

Abstract

Amaç: Odonotojenik Keratokist çenelerde görülen en
agresif kistlerdendir. Dental lamina artıklarından gelişir, nüks ve dokulara
infiltrasyon özelliği vardır.
Dentigeröz kist ikinci en
çok görülen odontojenik kisttir ve çoğu zaman semptom vermez
. Bu olgu
sunumunda geniş yerleşimli bu iki kistin marsupyalizasyon vakası sunulmaktadır

Olgu Sunumu: Her iki olguda, klinik ve radyolojik muayenesi
sonrası mandibula yerleşimli, ağrısız, intraoral ve ekstraoral ekspansiyon
yapmamış geniş radyolüsent lezyon tespit edildi.
Lokal
anestezi altında ilgili bölgelerden tam kalınlık flep kaldırılarak kemikte
kavite açıldı
. Kist sıvısı boşaltılarak kist
kavitesi yıkandı ve kavite açıklığı korunacak şekilde gaz iodoform suture
edildi.

Sonuçlar: Odontojenik
keratokist ve dentigeröz kist çoğunlukla mandibula posterior bölgede görülen ve
büyük boyutlara ulaşabilen lezyonlardır. Tedavide lezyonun büyüklüğüne göre
enükleasyon ve marsupyalizasyon yapılabilir. Operasyon sonrası histopatolojik
inceleme yapılmalı ve
  hastalar uzun
dönem takibi edilmelidir.

Anahtar Kelimeler: Keratokist, dentigeröz kist, marsupyalizasyon

References

  • 1. Partsch C. Uber kiefercysten. Deutsche Monatsschrift Fur Zahnheilkunde 10, 271, Quoted from Pogrel, MA, 2005. Treatment of keratocysts: The case for decompression and marsupialization. J Oral Maxillofac Surg. 1892;63:1667-1673.
  • 2. Tolstunov L. Marsupialization catheter. Journal of Oral and Maxillofacial Surgery. 2008;66(5):1077-1079.
  • 3. Pogrel MA. Treatment of keratocysts: The case for decompression and marsupialization. Journal of oral and maxillofacial surgery. 2005;63(11):1667-1673.
  • 4. Sun R, Cai Y, Wu Y, et al. Marsupialization facilitates movement of the cystic lesion-associated deeply impacted mandibular third molar in spite of its mature roots. Medicina oral, patologia oral y cirugia bucal. 2017;22(5):e625.
  • 5. Gao L, Wang X-L, Li S-M, et al. Decompression as a treatment for odontogenic cystic lesions of the jaw. Journal of Oral and Maxillofacial Surgery. 2014;72(2):327-333.
  • 6. Ghandour L, Bahmad HF, Bou-Assi S. Conservative Treatment of Dentigerous Cyst by Marsupialization in a Young Female Patient: A Case Report and Review of the Literature. Case reports in dentistry. 2018;2018.
  • 7. Al-Moraissi EA, Pogrel MA, Ellis III E. Enucleation with or without adjuvant therapy versus marsupialization with or without secondary enucleation in the treatment of keratocystic odontogenic tumors: A systematic review and meta-analysis. Journal of Cranio-Maxillofacial Surgery. 2016;44(9):1395-1403.
  • 8. Wushou A, Zhao Y-J, Shao Z-M. Marsupialization is the optimal treatment approach for keratocystic odontogenic tumour. Journal Of Cranio-Maxillofacial Surgery. 2014;42(7):1540-1544.
  • 9. Borghesi A, Nardi C, Giannitto C, et al. Odontogenic keratocyst: imaging features of a benign lesion with an aggressive behaviour. Insights Imaging. 2018.
  • 10. Madras J, Lapointe H. Keratocystic odontogenic tumour: reclassification of the odontogenic keratocyst from cyst to tumour. Tex Dent J. 2008;125(5):446-454.
  • 11. Pogrel MA. Decompression and marsupialization as a treatment for the odontogenic keratocyst. Oral and Maxillofacial Surgery Clinics. 2003;15(3):415-427.
  • 12. Ertas Ü, Yavuz MS. Interesting eruption of 4 teeth associated with a large dentigerous cyst in mandible by only marsupialization. Journal of oral and maxillofacial surgery. 2003;61(6):728-730.
  • 13. Martínez-Pérez D, Varela-Morales M. Conservative treatment of dentigerous cysts in children: a report of 4 cases. Journal of oral and maxillofacial surgery. 2001;59(3):331-333.
  • 14. Fujii R, Kawakami M, Hyomoto M, et al. Panoramic findings for predicting eruption of mandibular premolars associated with dentigerous cyst after marsupialization. Journal of Oral and Maxillofacial Surgery. 2008;66(2):272-276.
  • 15. Nishide N, Hitomi G, Miyoshi N. Irrigational therapy of a dentigerous cyst in a geriatric patient: a case report. Special Care in Dentistry. 2003;23(2):70-72.
  • 16. Warburton G, Shihabi A, Ord RA. Keratocystic odontogenic tumor (KCOT/OKC)—Clinical guidelines for resection. Journal of maxillofacial and oral surgery. 2015;14(3):558-564.
  • 17. Mejia JL, Donado JE, Basrani B. Active nonsurgical decompression of large periapical lesions–3 case reports. J Can Dent Assoc. 2004;70(10):691-694.
  • 18. Bouquot JE. Odontogenic cysts and tumors. In: Neville BW, Damm DD, Allen CM,eds Oral and Maxillofacial Pathology 2nd ed Philadelphia: WB Saunders. 2002:683-687.
There are 18 citations in total.

Details

Primary Language Turkish
Journal Section Case Report
Authors

Mehmet Melih Ömezli 0000-0002-6606-6593

Ferhat Ayrancı 0000-0001-7126-5696

Hale Yurtyapan This is me 0000-0002-5889-2078

Kadircan Kahveci 0000-0001-8532-3367

Publication Date August 31, 2021
Submission Date April 8, 2019
Published in Issue Year 2021 Volume: 8 Issue: 2

Cite

Vancouver Ömezli MM, Ayrancı F, Yurtyapan H, Kahveci K. Büyük boyutlara ulaşmış odontojenik kistlerin tedavisinde konservatif yaklaşım: İki olgu sunumu. Selcuk Dent J. 2021;8(2):561-5.