J Contemp Dent Pract ;22 9 — Aim and objective: The aim of this paper is to present, with a series of clinical cases, some advantages of a modified surgical technique using fixed bone flaps in an approach to voluminous maxillary or mandibular odontogenic cysts excluding keratocysts and highlight the positive impact on the healing of mucus and bone tissues. Background: The surgical approach of the enucleation of voluminous maxillary cysts is generally realized with a subtractive osteoplasty.
The major problem with this kind of procedure is frequent fibrous healing or scar formation of the cavity due to mucosal invagination, especially for large lesions more than 2 cm in diameter. Several techniques have been proposed to limit these side effects. Very contrasting results have been observed in the techniques with graft or exogenous materials, and the scarring effects on mucus and bone tissues are poorly described. In situations where a vestibular cortical bone remains, our modification of the former technique is the use of this bone like a repositioned flap.
Technique: The present study is a cases series and was carried out on 20 adult patients with maxillary or mandibular cystic lesions larger than 25 mm. For all the patients, our modified technique consisted of using a bone flap to expose more widely the site and to carry out the enucleation of the cyst. Repositioning the flap in the final stage of the operation with osteosynthesis material allowed controlled mucosal and bone healing confirmed by clinical and radiographic follow-up. Conclusion: In all cases of our study, no invagination of the soft tissues in the cystic cavity was observed and postoperative bone volumes were identical to the initial state.
Only minor postoperative complications were observed in three cases. Clinical significance: A bone flap approach seems to allow a tissue interception, thus better control of mucosal and bone healing, which is borne out by the clinical and radiographic controls 24 months after surgery. Keywords: Bone flap, Cystectomy, Odontogenic cysts, Oral surgery.
Jaw cysts are common pathologies in the oral and maxillofacial regions. The localization of odontogenic jaw cysts is very much dependent on the origin of the cyst and their expansion depends on their preoccupied anatomic area. They are usually characterized by a small and asymptomatic growth that mostly results in large cavities. The discovery of a voluminous maxillary or mandibular cyst 25 mm or more is generally due to the chance because it is seen on an X-ray and may compromise the initial treatment plan of the patient.
