Decompression and cystectomy of the odontogenic keratocysts of the mandible: a clinical study.

Objectives: Owing to the aggressive nature of OKC's if one could stop or even reverse the growth of the cyst with a simple procedure like decompression, regardless of the histologic type, it would be an alternative to radical and disfiguring surgery.

Methods: Eight patients who were diagnosed with Odontogenic keratocyst of the mandible were chosen and the first stage of treatment being, insertion of the decompression stent into the most prominent or dependent part of the cystic cavity. Then based on assessment of regular second monthly OPG radiograph the second stage ie. Enucleation of the cyst and treatment of the cystic cavity with Carnoy's solution was carried out, when the size of the cystic cavity had decreased.

Results: The radiographs of all the patients were analyzed at a two month interval and compared with the pre operative radiograph. The percentage of change in radiodensity of the lesion ranged from 35.15% to 66.16% with a mean decrease of 53.85%. This also indicated that the quantum of bone regeneration which occurred simultaneously and as observed during the cystectomy procedure was commendable.

Conclusion: Reduction of surgical morbidity while preserving anatomy and function, is the greatest advantage of decompression, however one should not forget the emphasis on the value of long term studies needed to be carried out with regular follow-up, to keep a check on those patients treated with decompression.