Decompression drainage (marsupialization) in the treatment of extensive jaw cysts

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Abstract

Odontogenic cysts of the jaw are one of the most common diseases of the maxillofacial region, the main methods of treatment of which are cystotomy and cystectomy. Despite the widespread use of these surgical methods of treatment — they are not without drawbacks. The presented clinical material shows the possibility of treating a patient with a large cavity formation of the jaw body by decompression drainage (marsupialization). The proposed surgical manual can be used either in isolation (the main method of treatment), or in combination with subsequent cystectomy. In modern domestic and foreign literature, publications devoted to this method of treatment of large and giant jaw cysts are rare, and therefore this clinical observation is presented.

About the authors

Maxim I. Muzikin

Military Medical Academy named after S.M. Kirov

Author for correspondence.
Email: muzikinm@gmail.com

MD, Cand. Sci. (Med.), assistant professor

Russian Federation, 6, Akademik Lebedev str., Saint Petersburg

Arseniy A. Golovko

Military Medical Academy named after S.M. Kirov

Email: senyagolovko@mail.ru
Russian Federation, 6, Akademik Lebedev str., Saint Petersburg

Mikhail V. Melnikov

Military Medical Academy named after S.M. Kirov

Email: pkmisha1311@gmail.com
Russian Federation, 6, Akademik Lebedev str., Saint Petersburg

Andrey K. Iordanishvili

Military Medical Academy named after S.M. Kirov

Email: professoraki@mail.ru
ORCID iD: 0000-0003-0052-3277

MD, Dr. Sci. (Med.), Professor

Russian Federation, 6, Akademik Lebedev str., Saint Petersburg

Vyacheslav A. Ratnikov

North-West District Scientific and Clinic Center named after L.G. Sokolov

Email: dr.ratnikov@mail.ru

MD, Dr. Sci. (Med.), Professor

Russian Federation, Saint Petersburg

References

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  4. Iordanishvili AK, Tolmachyov IA, Muzikin MI, Golovko AA. Professional errors and defects in the provision of medical care in the dental rehabilitation of adult patients. Vestnik Rossijskoj Voenno-medicinskoj akademii. 2016;53(1):50–55. (In Russ).
  5. Ji-Su Oh. Clinical and histomorphometric evaluation of decompression followed by enucleation in the treatment of odontogenic keratocyst. Journal of Dental Sciences. 2018; (13):329–333.
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Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. Orthopantomogram of patient I., 58 years old, initial clinical picture.

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3. Fig. 2. Patient I., stages of treatment. a — the initial clinical situation in the oral cavity; b — tooth extraction 3.4; c — active aspiration drainage of the cyst contents; d — a silicone tube for decompression drainage is installed and fixed.

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4. Fig. 3. Patient I.: bone tissue growth in the area of the defect at the stages of decompression drainage, sections of a computed tomogram. a, b, c — the initial clinical situation; d, e, f — after 3 months; g, h, i — after 6 months; j, k, l — after 12 months.

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5. Fig. 4. Stages of cystectomy operation in patient I. a — complete restoration of bone tissue 2 months after removal of the drainage tube; b — formation of cuts for atraumatic removal of the anterior bone wall of the residual cystic cavity; c — removal of the cyst shell; d — fixation of the bone wall in its former place with micro-screws; e — appearance of the wound after suturing.

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6. Fig. 5. Orthopantomogram of patient I. before the start of dental rehabilitation for partial loss of teeth.

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7. Fig. 6. Surgical stage of treatment of partial absence of teeth of patient I. a — oral cavity before surgical treatment; b — bone tissue after regeneration; c — removal of micro-screws; d — formation of a bed for dental implants; e — restoration of anatomical relations in the wound and suturing.

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