Conservative Decompression in the Management of Odontogenic Keratocysts: Case Report
João Francisco Barbosa Cordeiro
Resident of department of Oral and Maxillofacial Surgery and Traumatology of the State University of Western Paraná, Brazil.
Rafael da Silva Vanolli
Undergraduate student at the State University of Western Paraná, Brazil.
Bruna Caroline Ruthes de Souza
Resident of department of Oral and Maxillofacial Surgery and Traumatology of the State University of Western Paraná, Brazil.
Nicolas Mazur
Resident of department of Oral and Maxillofacial Surgery and Traumatology of the State University of Western Paraná, Brazil.
Gabriel Luiz Linn
Resident of department of Oral and Maxillofacial Surgery and Traumatology of the State University of Western Paraná, Brazil.
Ricardo Augusto Conci
Preceptor of department of Oral and Maxillofacial Surgery and Traumatology of the State University of Western Paraná, Brazil.
Eleonor Álvaro Garbin Júnior
Preceptor of department of Oral and Maxillofacial Surgery and Traumatology of the State University of Western Paraná, Brazil.
Geraldo Luiz Griza
Preceptor of department of Oral and Maxillofacial Surgery and Traumatology of the State University of Western Paraná, Brazil.
Natasha Magro Érnica
Preceptor of department of Oral and Maxillofacial Surgery and Traumatology of the State University of Western Paraná, Brazil.
*Author to whom correspondence should be addressed.
Abstract
Aims: This study aims to assess the effectiveness of decompression as a conservative treatment for odontogenic keratocysts (OKCs), with emphasis on reducing recurrence rates, decreasing lesion size, and preserving adjacent anatomical structures. Additionally, it explores the combination of decompression with enucleation and other therapies to minimize recurrence risks.
Presentation of Case: This is a case study focusing on conservative management of OKCs using decompression, with enucleation performed when necessary.
A 15-year-old male patient with a mandibular OKC underwent decompression under local anesthesia. Preoperative radiographic evaluations were followed by aspirate puncture and placement of a thoracic drain to facilitate lesion size reduction. The patient was monitored over six months, with radiographic exams every 60 days to assess cyst shrinkage.
Discussion: The patient showed a significant reduction in lesion size following decompression, allowing for easier enucleation while preserving the bone cortex. A review of the literature supports decompression as an effective treatment; however, recurrence rates remain problematic when performed without adjunctive therapies. Combining decompression with enucleation resulted in lower recurrence rates and improved long-term outcomes.
Conclusion: Decompression is a promising conservative approach for managing OKCs, particularly when combined with enucleation and adjunctive treatments. This approach reduces lesion size and preserves critical structures, although recurrence remains a concern. Long-term follow-up and further research on recurrence mechanisms are essential to improving outcomes for patients treated with decompression for OKS.
Keywords: Odontogenic keratocyst, decompression, dental treatment