Tratamento de Extenso Tumor Odontogénico Ceratocístico por Descompressão e Complementação Cirúrgica com Solução de Carnoy

Abstract

The present paper reports the treatment of a large Odontogenic Keratocyst Tumor found in the mandible of a 24 year-old male patient. Odontogenic Keratocysts are aggressive benign lesions that have high recurrence indices. In the past, the main treatment of those tumors was by surgical resection. Nowadays the characteristics of the lesion are better understood, allowing the development of new therapies. Decompression treatment alone is related to the highest recurrence levels while extensive lesions treated by surgery only, can lead to great impairment and deformities. The combination of strategies that provide less invasive procedures and low recurrence indices are actually the main aim. In this way, we proposed a treatment by decompression and surgical complementation with Carnoy's solution. A latex drain was inserted into the pathological cavity in order to allow irrigation with saline solution by the patient itself three times a day, every day, during 1,5 years. The importance of the commitment of the patient was emphasized. The surgery was performed when the radiographic aspect of the lesion suggested that it had decreased in volume and was restricted to the mandible's body which took 1,5 year. The wisdom tooth and the second molar tooth, related with the lesion, were extracted, the lesion was removed by curettage and bone peeling with acrylic drills was performed. At last, Carnoy‘s solution was laid in the cavity for three minutes and washed out right after. Since Odontogenic Keratocysts may recur within 10 years or more, the patient will be, once a year, called for reevaluation during this period.