Potential role of active decompression with distraction sugosteogenesis for the management of odontogenic cystic lesions: a retrospective review of 10 cases.

PURPOSE: The aim of this paper is to describe active decompression and distraction sugosteogenesis as an alternative for the management of odontogenic cystic lesions. The technique, demographics, success rate, and complications will be presented. PATIENTS AND METHODS: A retrospective case series study design was implemented. This included patients found in our database from 2015 to 2018 with a diagnosis of any odontogenic cyst, in whom active decompression with distraction sugosteogenesis was implemented. The patient's medical history, demographics, radiographic characteristics of the cyst, technique/device employed, complications, and rate of success were recorded. RESULTS: The sample consisted of 10 patients, with a mean age of 19.6 years (range 14-34). Sixty percent of all cases occurred in male patients and 40% in females. Forty percent of cases were consistent with odontogenic keratocysts with all cysts presenting in the mandible. No maxillary cases were documented. Seventy percent of such lesions were unilocular and 30% multilocular. Cortical fenestration/perforation was documented in 30% of cases and 1 pathologic fracture was seen. Active decompression was performed for an average of 37 days (range 30-50 days). With this system, radiographic resolution occurred in 1-3 months in 50% of cases, 6-12 months in 30% of cases, and 12 months in 20% of cases. Mean follow-up was 24.3 months. No recurrence was documented. Complications included fistula development (2 cases), flap dehiscence (1 case), and the size of the intraoral unit. CONCLUSIONS: This investigation reviewed the authors' 5-year experience employing active decompression with distraction sugosteogenesis for the management of odontogenic cystic lesions and showed that this is a reliable alternative for the management of odontogenic cysts.

From Cystostomy to Active Decompression: The Surgeons' Battle Against Odontogenic Cysts.

Odontogenic cysts represent a challenge for oral and maxillofacial surgeons. Treatment options include resective surgery and conservative approaches. The purpose of this paper is to review the history of marsupialization/decompression and other techniques based on similar principles.

Inferior Meatal Antrostomy as a Prophylactic Maneuver to Prevent Sinusitis After Zygomatic Implant Placement Using the Intrasinusal Technique.

PURPOSE: To determine whether performing an inferior meatal antrostomy as a prophylactic intraoperative maneuver in patients who underwent zygomatic implant surgery significantly reduces the incidence of postoperative sinusitis. MATERIALS AND METHODS: A double-blind randomized controlled trial was implemented. The study included 44 patients seen at the Oral and Maxillofacial Surgery Department at Universidad El Bosque in Bogota, Colombia, who required zygomatic implant surgery. Patients were randomly allocated to either group 1 (without inferior meatal antrostomy) or group 2 (with inferior meatal antrostomy). Patients were evaluated clinically and radiographically 15 days and 3 months after surgery, and classified depending on whether they did or did not develop sinusitis. Results were analyzed using descriptive and bivariate statistics. The control group event rate, experimental group event rate, relative risk, relative risk reduction, absolute risk reduction, and number needed to treat values were calculated for further analysis. RESULTS: Three patients allocated to group 1 showed clinical and radiographic signs of sinusitis after zygomatic implant surgery, for an overall rate of sinusitis of 13.6%. No patient in group 2 developed clinical or radiographic signs of sinusitis. CONCLUSION: The results of this study suggest that performing an inferior meatal antrostomy as a prophylactic intraoperative maneuver in patients who require zygomatic implant surgery is an effective method to prevent postoperative sinusitis.

Zygomatic implants for the management of the severely atrophied maxilla: a retrospective analysis of 244 implants.

PURPOSE: The aim of this investigation was to describe the surgical techniques, success rate, prosthetic rehabilitation, complications, and demographics of patients undergoing zygomatic implant surgery. PATIENTS AND METHODS: A retrospective case series study design was implemented that included patients who received zygomatic implants identified in the database of the Department of Oral and Maxillofacial Surgery, Universidad El Bosque from 2009 to 2013. Contact information was retrieved from the charts and patients were asked to attend the department for a follow-up appointment. The population consisted of all patients found in the database and the sample included otherwise healthy patients living in Bogota, Colombia. Predictor variables were categorized into patient's medical history, demographics, surgical technique, and prosthetic rehabilitation. The outcome variable was the presence or absence of postoperative complications. Smokers, diabetics, and patients living outside Bogota were excluded. Patients also were excluded if their medical status had changed since zygomatic implant surgery. Descriptive statistics were computed for each study variable. RESULTS: Data of 95 patients were retrieved. The sample consisted of 80 patients in whom 244 implants were inserted. The sample's mean age was 55.5 years. One hundred eleven zygomatic implants were placed in women and 133 were placed in men, with an overall complication rate of 9.9%, with sinusitis the most frequent complication (7.5%). Other complications included paresthesia (0.4%) and oroantral fistula (0.4%). The follow-up period was 6 to 48 months. CONCLUSIONS: This investigation reviewed the authors' 4-year experience placing zygomatic implants and proved a reliable method for the treatment of the resorbed maxilla.