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


How to Cite

Cordeiro, João Francisco Barbosa, Rafael da Silva Vanolli, Bruna Caroline Ruthes de Souza, Nicolas Mazur, Gabriel Luiz Linn, Ricardo Augusto Conci, Eleonor Álvaro Garbin Júnior, Geraldo Luiz Griza, and Natasha Magro Érnica. 2024. “Conservative Decompression in the Management of Odontogenic Keratocysts: Case Report”. Journal of Cancer and Tumor International 14 (4):65-72. https://doi.org/10.9734/jcti/2024/v14i4268.