Reconstruction of extensive jaw defects induced by keratocystic odontogenic tumor via patient-customized devices

Abstract

Keratocystic odontogenic tumors can occur in any area of the maxilla or mandible. According to their size, location, and relations with surrounding structures, they are treated by cyst enucleation or enucleation after either marsupialization or decompression. Enucleation is performed when cysts are not large and when only minor damage to adjacent anatomical structures is expected. Although marsupialization and decompression follow the same basic bone-regeneration principle, which is to say, by reducing the pressure within the cyst, the former leaves a large defect after healing due to the large fistula necessary to induce the conversion of the cyst-lining epithelia to oral epithelia; the latter leaves only a relatively small defect, because of the continuous washing carried out by means of a tube inserted into a small hole in the cyst. In the latter case too, a decompressor appropriate for the focal position is required, owing to the importance of maintaining the device and controlling for oral hygiene. We report herein decompression treatment with a patient-customized device for an extensive cyst in the anterior region of the mandible.

Retrospective clinical study of multiple keratocystic odontogenic tumors in non-syndromic patients

“…Therefore, it is not easy to completely remove a KOT with a simple enucleation 12 . However, enucleation is currently the most common surgical method 13 14 15 . To lessen the recurrence rate, we should consider additional surgical methods after enucleation, such as cautery with chemicals (e.g., Carnoy's solution), or cryotherapy and peripheral ostectomy by using a round bur 15 16 .…”

Volume change pattern of decompression of mandibular odontogenic keratocyst

“…After some decompression period, surgical enucleation is followed by decompression. If the lesion enlarges and approaches a vital structure, decompression is more recommended [5, 6].…”

Decompression of Large Keratocystic Odontogenic Tumor: Review of Literature and Case Report

“…for periodic follow-ups [4]. Decompression of KCOT is a simple method for stimulating new bone formation due to the reduction in cystic pressure by creating a hole that connects the cystic cavity with the oral cavity which allows cystic fluid to evacuate [5]. Therefore, decompression should be considered when KCOT enlarges and approaches vital structures or weaken the jaw.…”