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Potential role of active decompression with distraction sugosteogenesis for the management of odontogenic cystic lesions: a retrospective review of 10 cases

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Abstract

Purpose

The aim of this paper is to describe active decompression and distraction sugosteogenesis as an alternative for the management of odontogenic cystic lesions. The technique, demographics, success rate, and complications will be presented.

Patients and methods

A retrospective case series study design was implemented. This included patients found in our database from 2015 to 2018 with a diagnosis of any odontogenic cyst, in whom active decompression with distraction sugosteogenesis was implemented. The patient’s medical history, demographics, radiographic characteristics of the cyst, technique/device employed, complications, and rate of success were recorded.

Results

The sample consisted of 10 patients, with a mean age of 19.6 years (range 14–34). Sixty percent of all cases occurred in male patients and 40% in females. Forty percent of cases were consistent with odontogenic keratocysts with all cysts presenting in the mandible. No maxillary cases were documented. Seventy percent of such lesions were unilocular and 30% multilocular. Cortical fenestration/perforation was documented in 30% of cases and 1 pathologic fracture was seen. Active decompression was performed for an average of 37 days (range 30–50 days). With this system, radiographic resolution occurred in 1–3 months in 50% of cases, 6–12 months in 30% of cases, and 12 months in 20% of cases. Mean follow-up was 24.3 months. No recurrence was documented. Complications included fistula development (2 cases), flap dehiscence (1 case), and the size of the intraoral unit.

Conclusions

This investigation reviewed the authors’ 5-year experience employing active decompression with distraction sugosteogenesis for the management of odontogenic cystic lesions and showed that this is a reliable alternative for the management of odontogenic cysts.

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References

  1. Tay JY, Bay BH, Yeo JF, Harris M, Meghji S, Dheen ST (2004) Identification of RANKL in osteolytic lesions of the facial skeleton. J Dent Res 83:349–353

    Article  CAS  Google Scholar 

  2. Kumamoto H, Ooya K (2004) Expression of parathyroid hormone–related protein (PTHrP), osteoclast differentiation factor (ODF)/receptor activator of nuclear factor-kappaB ligand (RANKL) and osteoclastogenesis inhibitory factor (OCIF)/osteoprotegerin (OPG) in ameloblastomas. J Oral Pathol Med 33:46–52

    Article  CAS  Google Scholar 

  3. Sandra F, Hendarmin L, Kukita T, Nakao Y, Nakamura N, Nakamura S (2005) Ameloblastoma induces osteoclastogenesis: a possible role of ameloblastoma in expanding in the bone. Oral Oncol 41:637–644

    Article  CAS  Google Scholar 

  4. Silva TA, Batista AC, Mendonça EF, Leles CR, Fukada S, Cunha FQ (2008) Comparative expression of RANK, RANKL, and OPG in keratocystic odontogenic tumors, ameloblastomas, and dentigerous cysts. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 105:333–341

    Article  Google Scholar 

  5. Andrade FR, Sousa DP, Mendonça EF, Silva TA, Lara VS, Batista AC (2008) Expression of bone resorption regulators (RANK, RANKL, and OPG) in odontogenic tumors. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 106:548–555

    Article  Google Scholar 

  6. Meghji S, Harvey W, Harris M (1989) Interleukin 1-like activity in cystic lesions of the jaw. Br J Oral Maxillofac Surg 27:1–11

    Article  CAS  Google Scholar 

  7. Toller PA (1970) The osmolality of fluids from cysts of the jaws. Br Dent J 129:275–278

    Article  CAS  Google Scholar 

  8. Kubota Y, Yamashiro T, Oka S, Ninomiya T, Ogata S, Shirasuna K (2004) Relation between size of odontogenic jaw cysts and the pressure of fluid within. Br J Oral Maxillofac Surg 42:391–395

    Article  CAS  Google Scholar 

  9. Yamaguchi M (2009) RANK/RANKL/OPG during orthodontic tooth movement. Orthod Craniofac Res 12:113–119

    Article  CAS  Google Scholar 

  10. report of two cases (2013) Carrera M, Borges Dantas D, Marchionni AM, Gerhardt de Oliveira M, Setúbal Andrade MG. Conservative treatment of the dentigerous cyst. Braz J Oral Sci 12:52–56

    Google Scholar 

  11. Partsch C (1892) Uber kiefercysten. Dtsch Mschr Zahnheilkd 10:271

    Google Scholar 

  12. Pogrel MA (2004) Marsupialization as a definitive treatment for the odontogenic Keratocyst. J Oral Maxillofac Surg 62:651–655

    Article  Google Scholar 

  13. Castro-Núñez J (2016) An innovative decompression device to treat odontogenic cysts. J Craniofac Surg 27:1316

    Article  Google Scholar 

  14. Castro-Núñez J, Rey D, Amaya L (2017) An innovative intracystic negative pressure system to treat odontogenic cysts. J Craniofac Surg 28:1883–1884

    Article  Google Scholar 

  15. Castro-Núñez J (2018) Active intracystic negative pressure could induce osteogenesis. J Craniofac Surg 29:e370–e371

    Article  Google Scholar 

  16. Castro-Núñez J (2018) Distraction sugosteogenesis: its biologic bases and therapeutic principles. J Craniofac Surg 29:2088–2095

    Article  Google Scholar 

  17. Tolstunov L (2008) Marsupialization catheter. J Oral Maxillofac Surg 66:1077–1079

    Article  Google Scholar 

  18. Castro-Núñez J (2016) Decompression of odontogenic cystic lesions: past, present, and future. J Oral Maxillofac Surg 74(104):e1-9

    Google Scholar 

  19. Ingber DE, Prusty D, Sun Z et al (1995) Cell shape, cytoskeletal mechanics, and cell cycle control in angiogenesis. J Biomech 28:1471–1484

    Article  CAS  Google Scholar 

  20. Ingber DE (1997) Tensegrity: the architectural basis of cellular mechanotransduction. Annu Rev Physiol 59:575–599

    Article  CAS  Google Scholar 

  21. Ichioka S, Shibata M, Kosaki K et al (1997) Effects of shear stress on wound-healing angiogenesis in the rabbit ear chamber. J Surg Res 72:29–35

    Article  CAS  Google Scholar 

  22. Argenta LC, Morykwas MJ (1997) Vacuum-assisted closure: a new method for wound control and treatment: clinical experience. Ann Plast Surg 38:563–577

    Article  CAS  Google Scholar 

  23. DeFranzo AJ, Argenta LC, Marks MW et al (2001) The use of vacuum-assisted closure therapy for the treatment of lower-extremity wounds with exposed bone. Plast Reconstr Surg 108:1184–1191

    Article  CAS  Google Scholar 

  24. Yang Z, Liu M, Zhang Y (2009) Effects of intermittent negative pressure on osteogenesis in human bone marrow-derived stroma cells. J Zhejiang Univ Sci B 10:188–192

    Article  Google Scholar 

  25. Swain LD, Cornet DA, Manwaring ME et al (2013) Negative pressure therapy stimulates healing of critical-size calvarial defects in rabbits. Bonekey Rep 2:1–8

    Article  Google Scholar 

  26. Sun Y, Zhang J, Qian N et al (2018) Comparison of the osteogenic differentiation of orofacial bone marrow stromal cells prior to and following marsupialization in patients with odontogenic cysts. Mol Med Rep 17:988–994

    CAS  PubMed  Google Scholar 

  27. Anavi Y, Gal G, Miron H et al (2011) Decompression of odontogenic cystic lesion: clinical long-term study of 73 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 112:164–169

    Article  Google Scholar 

  28. Lizio G, Freni-Sterrantino A, Ragazzini S et al (2013) Volume reduction of cystic lesions after surgical decompression: a computerised three-dimensional computed tomographic evaluation. Clin Oral Invest 17:1701–1708

    Article  Google Scholar 

  29. Enislidis G, Fock N, Sulzbacher I et al (2004) 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

    Article  Google Scholar 

  30. Park HS, Song IS, Seo BM et al (2014) The effectiveness of decompression for patients with dentigerous cysts, keratocystic odontogenic tumours, and unicystic ameloblastoma. J Korean Assoc Oral Maxillofac Surg 40:260–265

    Article  Google Scholar 

  31. Lizio G, Tomaselli L, Landini L et al (2017) Outcome of dentigerous cysts treated with marsupialization. Dentigerous cysts associated with impacted third molars in adults after decompression: a prospective survey of reduction in volume using computerised analysis of cone-beam computed tomographic images. Br J Oral Maxillofac Surg 55:691–696

    Article  CAS  Google Scholar 

  32. Schlieve T, Miloro M, Kolokythas A (2014) Does decompression of odontogenic cysts and cystlike lesions change the histologic diagnosis? J Oral Maxillofac Surg 72:1094–1105

    Article  Google Scholar 

Download references

Acknowledgements

The authors wish to express their gratitude to Dr Jairo Bustillo-Rojas at Pontificia Universidad Javeriana in Bogota, Colombia for his inputs on this paper.

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Authors and Affiliations

  1. Oral and Maxillofacial Surgery Department, Clínica San Rafael, Orthodontics Residency Program, Universidad Antonio Nariño, Pereira, Colombia

    Sergio Trujillo-Saldarriaga

  2. Oral and Maxillofacial Surgery, Villavicencio, Colombia

    Mayra Alejandra Cuéllar

  3. Oral and Maxillofacial Surgery, Montería, Colombia

    Carlos Alfaro-Portillo

  4. Oral and Maxillofacial Surgery Care Center, Medellín and Quibdó, Colombia

    Pedro Moreno-Rodríguez

  5. Oral and Maxillofacial Surgery Department, Hospital UNIBE, San José, Costa Rica

    Andrés Gómez-Delgado

  6. PGY2, Oral and Maxillofacial Surgery Residency Program, School of Dental Medicine, University of Puerto Rico – Medical Sciences Campus, San Juan, Puerto Rico

    Jaime Castro-Núñez

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  1. Sergio Trujillo-Saldarriaga
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  2. Mayra Alejandra Cuéllar
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  3. Carlos Alfaro-Portillo
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  4. Pedro Moreno-Rodríguez
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  5. Andrés Gómez-Delgado
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  6. Jaime Castro-Núñez
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Correspondence to Jaime Castro-Núñez.

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Trujillo-Saldarriaga, S., Cuéllar, M.A., Alfaro-Portillo, C. et al. Potential role of active decompression with distraction sugosteogenesis for the management of odontogenic cystic lesions: a retrospective review of 10 cases. Oral Maxillofac Surg 26, 239–245 (2022). https://doi.org/10.1007/s10006-021-00970-y

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