Treatment of a large radicular cyst – enucleation or decompression?

Stevo B Matijević; Bojan Jovičić; Marija Bubalo; Smiljka Dukić; Tatjana Čutović

doi:10.2298/5292

Stevo B Matijević Department of Oral Surgery, Military Medical Academy. Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Bojan Jovičić Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia; Department of Endodontics, Parodontology and Oral Medicine,Military Medical Academy. Belgrade, Serbia
Marija Bubalo Department of Oral Implantology, Military Medical Academy. Belgrade, Serbia
Smiljka Dukić Vojnomedicinska akademija.
Tatjana Čutović Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia; Department of Orthodontics, Clinic for Dentistry, Military Medical Academy. Belgrade, Serbia

DOI: https://doi.org/10.2298/5292

Keywords: mandible, odontogenic cysts, oral surgical procedures,

Abstract

Introduction. Radicular cysts treatment involves surgical approach, more or less aggressive. However, treatment of large cystic lesions, including radicular cysts, causes some of dilemmas concerning the choice of the surgical method, especially the degree of radicalism. Case report. We presented a 65-year-old male patient with large radicular cyst in the mandible. A large elliptical multilocular radiolucency, located in the left side of the mandible, being in close vicinity to the mandibular canal, was registered at the orthopantomographic radiography. There was a risk of pathological fracture of the mandible. However, the cyst was completely removed by enucleation without intraoperative and postoperative complications. Conclusion. The presented case support the opinion that careful enucleation of large mandibular cysts may be done without complications, such as damages of surrounding anatomical structures or mandibular fracture. The authors indicate reasons for strong support of the undertaken surgical approach of treating large radicular cysts in the mandible.

Author Biographies

Stevo B Matijević, Department of Oral Surgery, Military Medical Academy. Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia

Klinika za stomatologiju, Odeljenje za oralnu hirurgiju.

Doc. dr sci. stom.

Bojan Jovičić, Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia; Department of Endodontics, Parodontology and Oral Medicine,Military Medical Academy. Belgrade, Serbia

Klinika za stomatologiju, Odeljenje za endodonciju, parodontologiju i oralnu medicinu.

Doc. dr sci. stom.

Marija Bubalo, Department of Oral Implantology, Military Medical Academy. Belgrade, Serbia

Klinika za stomatologiju, Odeljenje za oralnu implantologiju.

Dr sci stom.

Smiljka Dukić, Vojnomedicinska akademija.

Klinika za stomatologiju, Odeljenje za endodonciju, parodontologiju i oralnu medicinu.

Dr stom.

References

Morgenroth K, Philippou S. Oralpathologie II: Zahnsystem und Kiefer. Berlin: Springer; 1998. (German)

Iatrou I, Theologie-Lygidakis N, Leventis M. Intraosseous cystic le-sions of the jaws in children: a retrospective analysis of 47 consecutive cases. Oral Surg Oral Med Oral Pathol Oral Ra-diol Endod 2009; 107(4): 485−92.

Ettla T, Gosaua M, Saderb R, Reicherta ET. Jaw cysts - Filling or no filling after enucleation?, A review. J Cranio Maxillofac Surg 2012; 40(6): 485−93.

Chiapasco M, Rossi A, Motta JJ, Crescentini M. Spontaneous bone regeneration after enucleation of large mandibular cysts: a radiographic computed analysis of 27 consecutive cases. J Oral Maxillofac Surg 2000; 58(9): 942−8.

Ihan Hren N, Miljavec M. Spontaneous bone healing of the large bone defects in the mandible. Int J Oral Maxillofac Surg 2008; 37(12): 1111−6.

Swantek JJ, Reyes MI, Grannum RI, Ogle OE. A technique for long term decompression of large mandibular cysts. J Oral Maxillofac Surg 2012; 70(4): 856−9.

Enislidis G, Fock N, Sulzbacher I, Ewers R. Conservative treat-ment of large cystic lesions of the mandible: a prospective study of the effect of decompression. Br J Oral Maxillofac Surg 2004; 42(6): 546−50.

van Doorn ME. Enucleation and primary closure of jaw cysts. Int J Oral Surg 1972; 1(1): 17−25.