(45) Surgical Decompression as Treatment of Choice in the Management of Odontogenic Keratocysts in a Population of the Regional Hospital No 6 of the Mexican Social Security Institute in Tamaulipas, Mexico

Abstract: A clinical study is carried out in patients with a diagnosis of odontogenic keratocyst who attended the Regional Hospital No. 6 of the Mexican Institute of Social Security in Madero City, Tamaulipas Mexico, from June 2020 to December 2022. The ages of the patients ranged from 22 to 47 years of age. Cone beam tomography studies were carried out, in which radiolucent lesions were identified with the absence of dental organs inside, osteolytic appearance in both the maxilla and mandible. Surgery procedures under general anesthesia were scheduled, consisting of prior aspiration puncture, obtaining thick whitish material associated with keratin content, later marsupialization and placement of a drainage attachment consisting of a Luer-Lock syringe that served as a drainage and decompression route was performed. of bone lesions. The Luer-Lock drainage attachment was kept in psicion for 16 weeks, being withdrawn when the marsupialization contracted and scar tissue formed inside the bone cavity. At 21 weeks, epithelial closure was observed by second intention, carrying out the control by means of panoramic radiography. The initial pharmacological management was with Ceftriaxone 1 g every 12 hours x 7 days, celecoxib 200 mg every 12 hours x 10 days and local mechanical cleaning using irrigations once a day. The patients are currently under clinical and radiographic control on a regular basis.
The odontogenic keratocyst is a histological type of developmental odontogenic cysts whose highest incidence occurs between the second and third decades of life, and may have a second time of frequent appearance around the fifth decade. The areas of the lower third molar and the mandibular angle are the most affected, from where the lesion progresses towards the ramus and the body. Among the other odontogenic cysts, this is of great importance due to the high recurrence rate located between 25 and 60%, in addition to presenting histopathological characteristics that differentiate it from other cystic lesions.

Fig No 1. 3D Tomography showing a multilocular osteolytic lesion in the region of the left mandibular ascending ramus.


Fig No 2 Pre-surgical diagnostic aspiration puncture obtaining clinically compatible semi-solid material with keratin content which was later corroborated by histopathological study.


Fig No 3 Placement of the decompression device with intracavitary Luer-Lock syringe and with fastening to the buccal mucosa.