Descompressão de quistos odontogénicos: uma alternativa à cirurgia?

Abstract

Introduction: Odontogenic cysts occur relatively often among head and neck pathologies, thus it is crucial to make a correct diagnosis to choose the best treatment. The decompression, is a recent technique, which arises as an alternative to surgical treatments. Therefore, our aim was to assess the effectiveness and safety of cyst decompression. Methods: 14 patients who had been surgically treated to odontogenic cysts with more than 15 mm were selected. They were subjected to a control visit, where we made a clinical and radiographic update of the area previously occupied by the injury. Results: We found a higher prevalence of radicular cysts (78,57%). 64,29% cysts of the sample were close to vital structures, such as inferior alveolar nerve, mental nerve, nasal cavity and developing teeth. Cysts occurrence was higher in the fourth quadrant (42,86%) and the average size was 639,50 mm2. The technique more often used was the enucleation (85,71%). Although 28,57% were asymptomatic, constituting a radiographic finding, the more frequent signs and symptoms were swelling (21,43%) and swelling and drainage (21,43%) through a fistula or through a decayed tooth. Discussion: It is very important to evaluate a number of factors that are critical to the success of cyst decompression, such as: cyst size, proximity of vital structures, patient’s age and significance of the impacted tooth. The outcomes of this technique are strongly dependent on the cooperation of the patient, who has to attend appointments more often and has to make a proper hygiene of the intracystic area. Conclusion: Decompression is a conservative and an alternative technique to surgery that decreases the probability of sequelae upon large cyst’s treatment, which appears to be safe and effective.