J Korean Assoc Oral Maxillofac Surg.  2017 Apr;43(2):83-87. 10.5125/jkaoms.2017.43.2.83.

The effect of decompression as treatment of the cysts in the jaws: retrospective analysis

• Lee ST
• Kim SG
• Moon SY
• Oh JS
• You JS
• Kim JS

• KMID: 2377010
• DOI: http://doi.org/10.5125/jkaoms.2017.43.2.83

Abstract

OBJECTIVES
The purpose of this study is to evaluate the treatment efficacy of enucleation after decompression.
MATERIALS AND METHODS
A total of 17 patients with cystic lesion of the jaw were treated with decompression followed by enucleation. Pre- and postdecompression panoramic radiographs were analyzed.
RESULTS
The mean percentage of reduction after decompression was 64%. The reaction was graded as good (>80%) in five patients (29.4%), moderate (50%-80%) in nine patients (52.9%), and poor (<50%) in three patients (17.6%). The reduction rate of larger cystic lesions was faster than that of smaller lesions. However, the reduction rate was not affected by age. The duration of follow-up ranged from one to eight years. There were no complications, and one case recurred.
CONCLUSION
Decompression is an effective method for the initial treatment of jaw cysts.

Keyword

Decompression; Jaw cysts; Odontogenic cyst

MeSH Terms

Decompression*
Follow-Up Studies
Humans
Jaw Cysts
Jaw*
Methods
Odontogenic Cysts
Retrospective Studies*
Treatment Outcome

Figure

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  Fig. 1 Intraoral view of an individual obturator inserted into a cystic cavity.

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  Fig. 2 Age and sex distribution of 17 patients with cystic lesions.

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  Fig. 3 Change in lesion size, measured by percentage of lesion area reduction.

Reference

1. Kolokythas A, Fernandes RP, Pazoki A, Ord RA. Odontogenic keratocyst: to decompress or not to decompress? A comparative study of decompression and enucleation versus resection/peripheral ostectomy. J Oral Maxillofac Surg. 2007; 65:640–644. PMID: 17368357.

2. Dammer R, Niederdellmann H, Dammer P, Nuebler-Moritz M. Conservative or radical treatment of keratocysts: a retrospective review. Br J Oral Maxillofac Surg. 1997; 35:46–48. PMID: 9043004.

3. Nakamura N, Higuchi Y, Tashiro H, Ohishi M. Marsupialization of cystic ameloblastoma: a clinical and histopathologic study of the growth characteristics before and after marsupialization. J Oral Maxillofac Surg. 1995; 53:748–754. PMID: 7595787.

4. Eyre J, Zakrzewska JM. The conservative management of large odontogenic keratocysts. Br J Oral Maxillofac Surg. 1985; 23:195–203. PMID: 3159419.

5. Pogrel MA. Decompression and marsupialization as a treatment for the odontogenic keratocyst. Oral Maxillofac Surg Clin North Am. 2003; 15:415–427. PMID: 18088693.

6. Pogrel MA. Treatment of keratocysts: the case for decompression and marsupialization. J Oral Maxillofac Surg. 2005; 63:1667–1673. PMID: 16243185.

7. Nakamura N, Mitsuyasu T, Mitsuyasu Y, Taketomi T, Higuchi Y, Ohishi M. Marsupialization for odontogenic keratocysts: long-term follow-up analysis of the effects and changes in growth characteristics. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002; 94:543–553. PMID: 12424446.

8. Marker P, Brøndum N, Clausen PP, Bastian HL. Treatment of large odontogenic keratocysts by decompression and later cystectomy: a long-term follow-up and a histologic study of 23 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996; 82:122–131. PMID: 8863300.

9. 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. 2004; 42:546–550. PMID: 15544886.

10. 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. 2011; 112:164–169. PMID: 21194990.

11. August M, Faquin WC, Troulis MJ, Kaban LB. Dedifferentiation of odontogenic keratocyst epithelium after cyst decompression. J Oral Maxillofac Surg. 2003; 61:678–683. PMID: 12796876.

12. Rao S, Rao S. Decompression as a treatment for odontogenic cystic lesions of the jaw. J Oral Maxillofac Surg. 2014; 72:1231.

13. Brøndum N, Jensen VJ. Recurrence of keratocysts and decompression treatment. A long-term follow-up of forty-four cases. Oral Surg Oral Med Oral Pathol. 1991; 72:265–269. PMID: 1717918.

14. Forssell K, Sainio P. Clinicopathological study of keratinized cysts of the jaws. Proc Finn Dent Soc. 1979; 75:36–45. PMID: 93745.

15. Shudou H, Sasaki M, Yamashiro T, Tsunomachi S, Takenoshita Y, Kubota Y, et al. Marsupialisation for keratocystic odontogenic tumours in the mandible: longitudinal image analysis of tumour size using 3D visualised CT scans. Int J Oral Maxillofac Surg. 2012; 41:290–296. PMID: 22113115.