Simple Method for Securing a Decompression Tube for Odontogenic Cysts and Tumors: A Technical Note

Abstract

Decompression of odontogenic cysts and certain odontogenic tumors is a straightforward procedure used very commonly in the treatment of these entities. The goals for use of the decompression technique are usually determined by the size, location, and type of the pathology encountered. The most common reason for incorporating the decompression technique in the treatment algorithm for an odontogenic entity is the keratocystic odontogenic tumor. Several “decompression tubes” have been described and successfully used for this purpose. Some of the common problems encountered during the course of this type of treatment, which is extended over several months, originate from the size of the decompression tube itself and/or the trauma to the soft tissues from resorbable or nonresorbable sutures, or malposition or dislodgment of the tube. Although these are not major complications, they contribute to the discomfort and inconvenience for the patient and the clinician. The aim of this technical note is to describe a straightforward way of securing a polyethylene tube, commonly used for decompression, to minimize the trauma to the surrounding soft tissues, and to maximize retention in the proper location and position in relation to the cyst or tumor. Twenty-two patients were treated with this approach at our institution. The technique involves using a 28-gauge stainless steel ligature wire that secures the tube around the tooth/teeth immediately adjacent to the site of the lesion. In this manner, the soft tissues around the tube are not traumatized from any suture material or tube displacement because the position is secured with a wire, and adequate oral hygiene can be performed easily. Additionally, tube length adjustments may be required often during the treatment course, and these may be performed in a noninvasive fashion, and without the need for administration of local anesthesia.