Long-term investigation of decompression as a definitive treatment for mandibular cysts associated with impacted third molars

Abstract

Background: Clinicians sometimes use decompression for secondary, low-risk cyst enucleation. The authors explored whether the decompression of dentigerous cysts associated with third molars is a reliable, long-term, definitive treatment option.

Methods: The authors monitored 25 mandibular cysts associated with impacted third molars in adults after surgical decompression without the extraction of the related tooth for a mean (standard deviation) time of 37 (15) months (range, 12-71 months). The authors carefully evaluated the postoperative clinical situation and the extent of radiographic shrinkage.

Results: A minimal epithelial slit remained patent in all patients. All lacked clinical problems, had no need for further intervention, and exhibited persistent impaction of the teeth. The cyst reduction rate calculated on panoramic radiographs ranged from 63.4% to 98.8% (mean [standard deviation] 87.5% [10.6%]) and was statistically significant (P < .05). In 13 patients, the reduction rate was greater than 90%.

Conclusions: Decompression triggered marked radiographic reductions of cysts when epithelial communication persisted. The situation stabilized after the first 6 through 8 months, and no further intervention was required.

Practical implications: It is risky to enucleate cysts associated with impacted third molars and extract the molars. Clinicians can solve the problem in dental practice by using surgical decompression.

Keywords: Decompression; cysts; impacted third molars; prospective evaluation.