Comparison of wall removal type versus wall retaining type of decompression for treating large mandibular odontogenic cysts

Abstract

Objective To evaluate the differences between two types of decompression for treating large mandibular odontogenic cysts. Materials and methods This retrospective, cohort study included patients who were diagnosed for large mandibular odontogenic cysts from January 2015 to April 2018 and underwent two different types of decompression based on removal or retention of the cyst wall. The primary outcome was the percentage of the residual cyst area within 1 year after surgery. We used the propensity score matching (PSM) to balance the covariates of the two groups, and the primary outcome was analyzed by the non–inferiority test. Results A total of 93 cases were included in our study. After 1 year, the wall removal group was non–inferior to the wall retaining group in terms of cyst area, cyst volume, and the difference between the HU values of the original cyst region and the normal mandible. In subgroup analysis, we found there were no differences between two groups in the percentage of patients in whom the cystic area was reduced by 90% after 1 year. Conclusion Our findings suggest that the wall removal group showed better results than the cyst wall retaining group in large mandibular odontogenic cysts.

A non-invasive system to manage impacted teeth associated with a large dentigerous cyst

“…The main disadvantages are related to the discomfort for the patient and compliance in packing and flushing the surgical wound (Marin et al, 2019). This method has been reported by other authors as a suitable approach for large dentigerous cysts (Bonavolontà et al, 2019;Oliveros-Lopez et al, 2017;Wang et al, 2020).…”

“…Small dentigerous cysts are treated successfully with enucleation (removal of the cyst). This procedure should not be applied to large cysts because it would leave an extensive edentulous area without bone and could lead to negative consequences (Wang et al, 2020). Treatment of large cysts aims to reduce the intraluminal pressure by decreasing progressively the size of the cyst and allowing the bone around the cystic cavity to grow.…”

Conservative management of dentigerous cyst in children: Report of two clinical cases

“…Indeed, the irrigation of the cyst cavity by a saline or antiseptic solution is mandatory to avoid infection. No specific technique has been demonstrated to be superior 20 …”

“…No specific technique has been demonstrated to be superior. 20 There are various factors to take into consideration when performing marsupialization such as patient age, size and cyst location and mainly patient cooperation. 21 This therapeutic approach can be considered alone or associated to subsequent enucleation.…”