[A clinical case of surgical treatment of a large odontogenic keratocyst].

Abstract

Objective: Analysis of a clinical case of successful removal of odontogenic keratocyst of the mandible using methods of differential diagnostic, clinical and X-ray analyses and by forming several bone windows.

Material and methods: The clinical case of a patient who applied to the clinic of the Russian University of Medicine for consultation and treatment is presented. For diagnostic purposes, computed tomography and histological examination were performed to determine the condition of bone tissue and teeth.

Results: Based on clinical and laboratory studies, the diagnosis of "Odontogenic keratocyst occupying the body, angle and branch of the mandible" was confirmed. Through the formed three windows, the cyst shell was removed without fragmentation. Bone tissue restoration was monitored for 4 years. For complete restoration of bone tissue, an audit was carried out, followed by the use of hydroxyapatite and a resorbable membrane, for complete restoration of bone tissue.

Conclusion: The creation of bone windows to isolate the cyst shell without fragmentation is the optimal approach to the treatment of large-sized odontogenic keratocysts. We guided the patient using the principle of both cystectomy and cystotomy, despite the removal of the keratocyst shell in full. The management of the patient by cystotomy, using iodophoric turunda, allowed to avoid complications associated with the formation of a large clot, and residual phenomena in case of recurrence after removal of the cyst shell. To enhance the formation of healthy bone tissue, we performed depulpation and resection of the roots of the teeth, which were at the defect level bone tissue, to improve the appositional bone growth.