Cystic lesions of the jaws. Study of a three-year period
Dimosthenis IGOUMENAKIS, Spyridon ATHANASIOU, Christos KRASADAKIS, Constantinos MOUROUZIS, Michael MEZITIS, George RALLIS
Department of Oral and Maxillofacial Surgery, General Hospital of Attica “KAT”, Greece (Head Coordinator: Dr G. Rallis)
Hellenic Archives of Oral & Maxillofacial Surgery (2014) 1, 1-10
SUMMARY: Cystic lesions of the jaws are common pathologic entity. Aim: The analysis of a case series of cystic lesions of the jaws. Material and Method: Retrospective study of the cases of cystic lesions, which were managed in our department during the years 2010 - 2012 was conducted. The following inclusion criteria of a case in the study were defined: maximum diameter of the lesion at least 2cm, surgical treatment of the lesion under general anesthesia and postoperative follow-up of the patient for at least one year. Results: 56 cases were analyzed. Average age of the patients was 48.2 years and the average maximum diameter of the lesions was 3.86cm. Almost all cases were managed by enucleation (49/56– 87.5%). Decompression was implemented in 5 cases (8.9%). In all cases, except for one where recurrence was observed, the result was cure of the lesion. The use of bone graft was correlated in statistically significant degree with seemingly quicker bone regeneration, but also with an increased risk of immediate postoperative wound dehiscence. Conclusions: Enucleation as well as decompression were proven to be good methods, as their use provided satisfactory results in all cases. The results of bone allograft application were controversial and therefore its use must be studied more thoroughly.
KEY WORDS: cysts, enucleation, decompression, bone graft
REFERENCES
Αγγελόπουλος Α, Παπανικολάου Σ, Αγγελοπούλου Ε: Σύγχρονη στοματική και γναθοπροσωπική παθολογία. Ιατρικές Εκδόσεις Λίτσας 2000, σελ. 487-495.
Anavi Y, Gal G, Miron H, Calderon S, Allon DM: Decompression of odontogenic cystic lesions: clinical long-term study of 73 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 112: 164- 169. 2011.
Barnes L, Everson JW, Reichert P, Sidransky D: World Health Organization Classification of tumours, classification and genetics of head and neck tumors, Lyon, France, 2005,
IARC Press. Bodner L: Osseous regeneration in the jaws using deminerized allogenic bone implants. J Craniomaxillofac Surg. 26: 116-120. 1998
Chapelle K, Stoelinga P, de Wilde P, Brouns JJA, Vorsmit R: Rational approach to diagnosis and treatment of ameloblastomas and odontogenic keratocysts. Br J Oral Maxillofac Surg. 42: 381-390. 2004
Crawley TE, Caugars GE, Gunsolley JC: Odontogenic Keratocysts: A Clinical and Histologic Comparison of the Parakeratin and Orthokeratin Variants. J Oral Maxillofac Surg. 50: 22-26. 1992
Enislidis G, Fock N, Sulzbacher I, Ewers R: Conservative treatment of large cystic lesions of the mandible: a prospective study of the effect of decompression. Br J Oral Maxillofac Surg. 42: 546-550. 2004
Ettl T, Gosau M, Sader R, Reichert TE: Jaw cysts- Filling or no filling after enucleation? A review. J Craniomaxillofac Surg. 40: 485-493. 2004
Frame JW, Browne MR, Brady CL: Biologic Basis for Interpositional Autogenous Bone Grafts to the Mandible. J Oral Maxillofac Surg. 40: 407-411. 1982
Guven O, Keskin A, Akal UK: The incidence of cysts and tumors around third molars. Int J Oral Maxillofac Surg. 29: 131-135. 2000
Hadjipetrou L, Antoniades V, Kavadias S, Antoniades K: Solitary cysts of the mandible, report of four cases. Hell Arch Oral Maxillofac Surg. 6: 21-29. 2005 Hjorting-Hansen E, Schou S, Worsaae N: Suction Drainage in the Postsurgical Treatment of Jaw Cysts. J Oral Maxillofac Surg. 51: 630- 633. 1993
Iatrou I, Theologie-Lygidakis N, Leventis M: Intraosseous cystic lesions of the jaws in children: A retrospective analysis of 46 consecutive cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 107: 485-492. 2009
Kakarantza-Angelopoulou E, Nicolatou O: Odontogenic keratocysts: Clinicopathologic study of 87 cases. J Oral Maxillofac Surg. 48: 593-599. 1990
Kreidler FJ, Raubenheimer EJ, van Heerden WFP: A retrospective analysis of 337 cystic lesions of the jaw-the Ulm experience. J Craniomaxillofac Surg. 21: 339-341, 1993
Leventis M, Eleftheriadis E, Papanicolaou S, Oikonomopoulou P, Vavouraki H, Khaldi L, Tosios K, Alexandridis C, Dontas I: The effect of autologous platelet rich plasma on the osteoinductive potential of allogenic demineralized bone matrix. An experimental pilot study in rabbits. Hell Arch Oral Maxillofac Surg. 3:141-156. 2010
Manor E, Kachko L, Puterman MB, Szabo G, Bodner L: Cystic Lesions of the Jaws– A Clinicopathologic Study of 322 Cases and Review of the Literature. Int J Med Sci. 9: 20-26. 2012
Matsumura S, Murakami S, Kakimoto N, Furukawa S, Kishino M, Ishida T, Fuchihata H: Histopathologic and radiographic findings of the simple bone cyst. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 85: 619-625. 1998
Matsuo A, Chiba H, Toyoda J, Abukawa H, Fujikawa K, Tsuzuki M, Watanabe M: Mandibular Reconstruction Using a Tray With Particulate Cancellous Bone and Marrow and Platelet-Rich Plasma by an Intraoral Approach. J Oral Maxillofac Surg. 69: 1807-1814. 2011
Neville B, Damm D, Allen C, Bouqouot J: Odontogenic Cysts and Tumors, In: Oral and Maxillofacial Pathology. Saunders 2002, pp 594- 598
Pogrel MA: Treatment of Keratocysts: The Case for Decompression and Marsupialization. J Oral Maxillofac Surg. 63: 1667-1673. 2005
Sager M, Ferrari D, Wieland M, Dard M, Becker J, Schwarz F: Immunohistochemical characterization of wound healing at two different bone graft substitudes. Int J Oral Maxillofac Surg. 41: 657-666. 2012
Stathopoulos P, Mezitis M, Cappatos C, Titsinides S, Stylogianni E: Cysts and Tumors Associated with Impacted Third Molars: Is Prophylactic removal Justified? J Oral Maxillofac Surg. 69: 405-408. 2011
Swantek JJ, Reyes MI, Grannum RI, Ogle OE: A technique for long term decompression of large mandibular cysts. J Oral Maxillofac Surg. 70: 856-859. 2012 Zhang LL, Yang R, Zhang L, McDonald-Jankowski LD, Poh CF: Dentigerous cyst: a retrospective clinicopathological analysis of 2082 dentigerous cysts in British Columbia, Canada. Int J Oral Maxillofac Surg. 39: 879-882. 2010
Department of Oral and Maxillofacial Surgery, General Hospital of Attica “KAT”, Greece (Head Coordinator: Dr G. Rallis)
Hellenic Archives of Oral & Maxillofacial Surgery (2014) 1, 1-10
SUMMARY: Cystic lesions of the jaws are common pathologic entity. Aim: The analysis of a case series of cystic lesions of the jaws. Material and Method: Retrospective study of the cases of cystic lesions, which were managed in our department during the years 2010 - 2012 was conducted. The following inclusion criteria of a case in the study were defined: maximum diameter of the lesion at least 2cm, surgical treatment of the lesion under general anesthesia and postoperative follow-up of the patient for at least one year. Results: 56 cases were analyzed. Average age of the patients was 48.2 years and the average maximum diameter of the lesions was 3.86cm. Almost all cases were managed by enucleation (49/56– 87.5%). Decompression was implemented in 5 cases (8.9%). In all cases, except for one where recurrence was observed, the result was cure of the lesion. The use of bone graft was correlated in statistically significant degree with seemingly quicker bone regeneration, but also with an increased risk of immediate postoperative wound dehiscence. Conclusions: Enucleation as well as decompression were proven to be good methods, as their use provided satisfactory results in all cases. The results of bone allograft application were controversial and therefore its use must be studied more thoroughly.
KEY WORDS: cysts, enucleation, decompression, bone graft
REFERENCES
Αγγελόπουλος Α, Παπανικολάου Σ, Αγγελοπούλου Ε: Σύγχρονη στοματική και γναθοπροσωπική παθολογία. Ιατρικές Εκδόσεις Λίτσας 2000, σελ. 487-495.
Anavi Y, Gal G, Miron H, Calderon S, Allon DM: Decompression of odontogenic cystic lesions: clinical long-term study of 73 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 112: 164- 169. 2011.
Barnes L, Everson JW, Reichert P, Sidransky D: World Health Organization Classification of tumours, classification and genetics of head and neck tumors, Lyon, France, 2005,
IARC Press. Bodner L: Osseous regeneration in the jaws using deminerized allogenic bone implants. J Craniomaxillofac Surg. 26: 116-120. 1998
Chapelle K, Stoelinga P, de Wilde P, Brouns JJA, Vorsmit R: Rational approach to diagnosis and treatment of ameloblastomas and odontogenic keratocysts. Br J Oral Maxillofac Surg. 42: 381-390. 2004
Crawley TE, Caugars GE, Gunsolley JC: Odontogenic Keratocysts: A Clinical and Histologic Comparison of the Parakeratin and Orthokeratin Variants. J Oral Maxillofac Surg. 50: 22-26. 1992
Enislidis G, Fock N, Sulzbacher I, Ewers R: Conservative treatment of large cystic lesions of the mandible: a prospective study of the effect of decompression. Br J Oral Maxillofac Surg. 42: 546-550. 2004
Ettl T, Gosau M, Sader R, Reichert TE: Jaw cysts- Filling or no filling after enucleation? A review. J Craniomaxillofac Surg. 40: 485-493. 2004
Frame JW, Browne MR, Brady CL: Biologic Basis for Interpositional Autogenous Bone Grafts to the Mandible. J Oral Maxillofac Surg. 40: 407-411. 1982
Guven O, Keskin A, Akal UK: The incidence of cysts and tumors around third molars. Int J Oral Maxillofac Surg. 29: 131-135. 2000
Hadjipetrou L, Antoniades V, Kavadias S, Antoniades K: Solitary cysts of the mandible, report of four cases. Hell Arch Oral Maxillofac Surg. 6: 21-29. 2005 Hjorting-Hansen E, Schou S, Worsaae N: Suction Drainage in the Postsurgical Treatment of Jaw Cysts. J Oral Maxillofac Surg. 51: 630- 633. 1993
Iatrou I, Theologie-Lygidakis N, Leventis M: Intraosseous cystic lesions of the jaws in children: A retrospective analysis of 46 consecutive cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 107: 485-492. 2009
Kakarantza-Angelopoulou E, Nicolatou O: Odontogenic keratocysts: Clinicopathologic study of 87 cases. J Oral Maxillofac Surg. 48: 593-599. 1990
Kreidler FJ, Raubenheimer EJ, van Heerden WFP: A retrospective analysis of 337 cystic lesions of the jaw-the Ulm experience. J Craniomaxillofac Surg. 21: 339-341, 1993
Leventis M, Eleftheriadis E, Papanicolaou S, Oikonomopoulou P, Vavouraki H, Khaldi L, Tosios K, Alexandridis C, Dontas I: The effect of autologous platelet rich plasma on the osteoinductive potential of allogenic demineralized bone matrix. An experimental pilot study in rabbits. Hell Arch Oral Maxillofac Surg. 3:141-156. 2010
Manor E, Kachko L, Puterman MB, Szabo G, Bodner L: Cystic Lesions of the Jaws– A Clinicopathologic Study of 322 Cases and Review of the Literature. Int J Med Sci. 9: 20-26. 2012
Matsumura S, Murakami S, Kakimoto N, Furukawa S, Kishino M, Ishida T, Fuchihata H: Histopathologic and radiographic findings of the simple bone cyst. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 85: 619-625. 1998
Matsuo A, Chiba H, Toyoda J, Abukawa H, Fujikawa K, Tsuzuki M, Watanabe M: Mandibular Reconstruction Using a Tray With Particulate Cancellous Bone and Marrow and Platelet-Rich Plasma by an Intraoral Approach. J Oral Maxillofac Surg. 69: 1807-1814. 2011
Neville B, Damm D, Allen C, Bouqouot J: Odontogenic Cysts and Tumors, In: Oral and Maxillofacial Pathology. Saunders 2002, pp 594- 598
Pogrel MA: Treatment of Keratocysts: The Case for Decompression and Marsupialization. J Oral Maxillofac Surg. 63: 1667-1673. 2005
Sager M, Ferrari D, Wieland M, Dard M, Becker J, Schwarz F: Immunohistochemical characterization of wound healing at two different bone graft substitudes. Int J Oral Maxillofac Surg. 41: 657-666. 2012
Stathopoulos P, Mezitis M, Cappatos C, Titsinides S, Stylogianni E: Cysts and Tumors Associated with Impacted Third Molars: Is Prophylactic removal Justified? J Oral Maxillofac Surg. 69: 405-408. 2011
Swantek JJ, Reyes MI, Grannum RI, Ogle OE: A technique for long term decompression of large mandibular cysts. J Oral Maxillofac Surg. 70: 856-859. 2012 Zhang LL, Yang R, Zhang L, McDonald-Jankowski LD, Poh CF: Dentigerous cyst: a retrospective clinicopathological analysis of 2082 dentigerous cysts in British Columbia, Canada. Int J Oral Maxillofac Surg. 39: 879-882. 2010
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