Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
권호 표지
DOI QR코드

DOI QR Code

Predicting risk factors for complications in jaw cyst treatment: insights from a retrospective study

  • Yei-Jin Kang (Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University) ;
  • Min-Keun Kim (Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University) ;
  • Seong-Gon Kim (Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University) ;
  • Young-Wook Park (Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University) ;
  • Ji-Hyeon Oh (Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University)
  • Received : 2024.10.16
  • Accepted : 2024.12.13
  • Published : 2025.02.28
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives: Clinical situations that make it challenging to differentiate odontogenic cysts from non-odontogenic cysts and benign tumors of the jaw include cases with cystic conditions accompanied by secondary infection, impacted teeth, cortical thinning and expansion, or external root resorption. This study aimed to identify risk factors for complications in patients undergoing cyst enucleation of the jaw, propose a clinical model, and determine the necessary indications for preoperative root canal of adjacent teeth. Materials and Methods: A review of surgical, pathological, and radiological reports, as well as medical records, was conducted. Pathological diagnosis, lesion size, history of preoperative endodontic treatment of the adjacent tooth, operator details, surgical procedures, age, gender, and complications (with severity) were analyzed. Results: This study involved 77 patients (55 men, 22 women) and found 10 complications. Procedure type (cyst enucleation only, apicoectomy and bone graft, or bone graft only) and lesion size were significant risk factors. Preoperative root canal therapy and men gender also tended to positively correlate with complications, while age was not a factor. Conclusion: Within the limitations of our study, additional procedures contributed to lower risk of complications with the exception of bone graft. A large cyst size was also associated with a higher risk of complications. It is important to consider the possibility of a second procedure and take thorough precautions to prevent infection when performing bone grafts. Patients should be informed of these risks in advance, scheduled for regular follow-up, and provided additional treatment when necessary.

Keywords

Acknowledgement

Prof. Kwang-Jun Kwon (Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University) advised the processing of collected data.

References

  1. Butt FM, Ogeng'o J, Bahra J, Chindia ML. Pattern of odontogenic and nonodontogenic cysts. J Craniofac Surg 2011;22:2160-2. https://doi.org/10.1097/scs.0b013e3182323fbe
  2. Sirotheau Corrêa Pontes F, Paiva Fonseca F, Souza de Jesus A, Garcia Alves AC, Marques Araújo L, Silva do Nascimento L, et al. Nonendodontic lesions misdiagnosed as apical periodontitis lesions: series of case reports and review of literature. J Endod 2014;40:16-27. https://doi.org/10.1016/j.joen.2013.08.021
  3. Korean Council of Professors of Oral and Maxillofacial Radiology. Oral and maxillofacial radiology. 4th ed. Narae Publishing; 2008.
  4. Andersson L, Kahnberg KE, Pogrel MA. Oral and maxillofacial surgery. Wiley-Blackwell; 2010.
  5. Kademani D, Tiwana P. Atlas of oral and maxillofacial surgery. Elsevier; 2016.
  6. Zhao Y, Liu B, Zhao YF. Controversies regarding the management of teeth associated with cystic lesions of the jaws. Chin J Dent Res 2019;22:81-92. https://doi.org/10.3290/j.cjdr.a42512
  7. Beck F, Lauterbrunner N, Lettner S, Stavropoulos A, Ulm C, Bertl K. Devitalization of adjacent teeth following maxillary sinus floor augmentation: a retrospective radiographic study. Clin Implant Dent Relat Res 2018;20:763-9. https://doi.org/10.1111/cid.12632
  8. Alharbi MA, Alghamdi A, Kattan SA, Austah O, Othman B, Haddad S, et al. The incidence of devitalization of vital teeth associated with pathologies of the jaws following surgical intervention: a mixed-case study. J Contemp Dent Pract 2023;24:750-6. https://doi.org/10.5005/jp-journals-10024-3567
  9. Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, et al. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 2009;250:187-96. https://doi.org/10.1097/sla.0b013e3181b13ca2
  10. Muzaffar AR, Nguyen TB, Baker L, Warren AJ. Does the use of particulate bone graft increase the incidence of postoperative infection in surgery for craniosynostosis? Cleft Palate Craniofac J 2015;52:e14-7. https://doi.org/10.1597/14-016
  11. Ludovichetti FS, De Biagi M, Bacci C, Bressan E, Sivolella S. Healing of human critical-size alveolar bone defects secondary to cyst enucleation: a randomized pilot study with 12 months follow-up. Minerva Stomatol 2018;67:148-55. https://doi.org/10.23736/ s0026-4970.18.04126-2
  12. Chen CJ, Brien EW. Early postoperative compilations of bone filling in curettage defects. J Orthop Surg Res 2019;14:261. https://doi.org/10.1186/s13018-019-1297-4
  13. Proops DW. Post-operative cleaning of head and neck cavities. J Laryngol Otol 1984;98:549-50. https://doi.org/10.1017/s0022215100147073
  14. Lin LM, Pascon EA, Skribner J, Gängler P, Langeland K. Clinical, radiographic, and histologic study of endodontic treatment failures. Oral Surg Oral Med Oral Pathol 1991;71:603-11. https://doi. org/10.1016/0030-4220(91)90371-i
  15. Siqueira JF Jr, Rôças IN. Microbiology and treatment of acute apical abscesses. Clin Microbiol Rev 2013;26:255-73. https://doi.org/10.1128/cmr.00082-12
  16. Nair PN. Apical periodontitis: a dynamic encounter between root canal infection and host response. Periodontol 2000 1997;13:121-48. https://doi.org/10.1111/j.1600-0757.1997.tb00098.x
  17. Abbott PV. Classification, diagnosis and clinical manifestations of apical periodontitis. Endod Top 2004;8:36-54. https://doi.org/10.1111/j.1601-1546.2004.00098.x
  18. Lim HK, Kim JW, Lee UL, Kim JW, Lee H. Risk factor analysis of graft failure with concomitant cyst enucleation of the jaw bone: a retrospective multicenter study. J Oral Maxillofac Surg 2017;75:1668-78. https://doi.org/10.1016/j.joms.2017.02.003
  19. Kloss FR, Gassner R. Bone and aging: effects on the maxillofacial skeleton. Exp Gerontol 2006;41:123-9. https://doi.org/10.1016/j.exger.2005.11.005
  20. Rowlands A. Risk factors associated with incorrect surgical counts. AORN J 2012;96:272-84. https://doi.org/10.1016/j.aorn.2012.06.012