The State of Art of Decompression in Management of Radicular Cysts

doi:10.13701/j.cnki.kqyxyj.2019.09.005

Abstract

Abstract: Radicular cysts are the common jaw cyst and are often treated by root canal treatment. For large radicular cysts, enucleation is necessary. Although enucleation can achieve satisfactory therapeutic effects, it increases the risks of damaging other vital structures and the roots of adjacent teeth. As an adjuvant treatment of large odontogenic cysts, marsupialization/decompression is less invasive and causes less complication, which has drawn attention from endodontists and had been successfully applied in recent years. Its mechanisms may include the release of intracysic pressure and enhancement of osteogenesis, drainage, and reduction of the IL-1 which mediates osteoclast formation, which therefore changes the microenvironment reducing division of epithelial cells. Decompression also facilitates drainage of the cystic exudate so that the root canal can be completely dried and sealed. The present paper aimed to review the developments of decompression as a supplementary procedure in the management of radicular cysts and conclude that decompression might be adopted as part of a comprehensive strategy for treatments of radicular cysts.

Key words: radicular cyst, decompression, root canal treatment, enucleation

HUANG Zijing, HU Xiaoli. The State of Art of Decompression in Management of Radicular Cysts[J]. Journal of Oral Science Research, 2019, 35(9): 837-840.

References

[1] Castro-Nunez J. Decompression of odontogenic cystic lesions: past, present, and future [J]. J Oral Maxillofac Surg, 2016, 74(1):101-104.
[2] Wushou A, Zhao YJ, Shao ZM. Marsupialization is the optimal treatment approach for keratocystic odontogenic tumour [J]. J Craniomaxillofac Surg, 2014,42(7):1540-1544.
[3] Lau SL, Samman N. Recurrence related to treatment modalities of unicystic ameloblastoma: a systematic review [J]. Int J Oral Max Surg, 2006, 35(8):681-690.
[4] Liang YJ, He WJ, Zheng PB, et al. Inferior alveolar nerve function recovers after decompression of large mandibular cystic lesions [J]. Oral Dis, 2015, 21(5):674-678.
[5] Gao L, Wang XL, Li SM, et al. Decompression as a treatment for odontogenic cystic lesions of the jaw [J]. J Oral Maxillofac Surg, 2014, 72(2):327-333.
[6] Asutay F, Atalay Y, Turamanlar O, et al. Three-dimensional volumetric assessment of the effect of decompression on large mandibular odontogenic cystic lesions [J]. J Oral Maxillofac Surg, 2016, 74(6):1159-1166.
[7] Kele A, Al In H. Use of endoVac system for aspiration of exudates from a large periapical lesion: a case report [J]. J Endod, 2015, 41(10):1735-1737.
[8] Sood N, Maheshwari N, Gothi R, et al. Treatment of large periapical cyst like lesion: a noninvasive approach: a report of two cases [J]. Int J Clin Pediatr Dent, 2015, 8(2):133-137.
[9] Lin LM, Huang GT, Rosenberg PA. Proliferation of epithelial cell rests, formation of apical cysts, and regression of apical cysts after periapical wound healing [J]. J Endod, 2007,33(8):908-916.
[10] Nair PN, Sundqvist G, Sjögren U. Experimental evidence supports the abscess theory of development of radicular cysts [J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2008, 106(2):294-303.
[11] Torabinejad M. The role of immunological reactions in apical cyst formation and the fate of epithelial cells after root canal therapy: a theory [J]. Int J Oral Surg, 1983, 12(1):14-22.
[12] Ricucci D, Siqueira JF, Loghin S, et al. Repair of extensive apical root resorption associated with apical periodontitis: radiographic and histologic observations after 25 years [J]. J Endod, 2014, 40(8):1268-1274.
[13] 周健,杜若鸿.颌骨囊肿的治疗方法及其临床应用[J].口腔颌面外科杂志,2012,22(4):229-232.
[14] Rodrigues JT, Dos Santos Antunes H, Armada L, et al. Influence of surgical decompression on the expression of inflammatory and tissue repair biomarkers in periapical cysts [J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2017,124(6):561-567.
[15] 张琛.根管充填的难点和误区[J].华西口腔医学杂志,2017,35(3):232-238.
[16] Anavi Y, Gal G, Miron H, et al. Decompression of odontogenic cystic lesions: clinical long-term study of 73 cases [J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2011, 112(2):164-169.
[17] Bernardi L, Visioli F, Nör C, et al. Radicular cyst: an update of the biological factors related to lining epithelium [J]. J Endod, 2015, 41(12):1951-1961.
[18] de Moraes M, da Rocha Neto PC, de Matos FR, et al. Immunoexpression of transforming growth factor beta and interferon gamma in radicular and dentigerous cysts [J]. J Endod, 2014, 40(9):1293-1297.
[19] Rahpeyma A, Khajehahmadi S. Marsupialization for treatment of jaw cysts: indications and limitations [J]. J Int Oral Health, 2016, 8(2):158-162.
[20] Allon DM, Allon I, Anavi Y, et al. Decompression as a treatment of odontogenic cystic lesions in children [J]. J Oral Maxillofac Surg, 2015, 73(4):649-654.
[21] Oliveros-Lopez L, Fernandez-Olavarria A, Torres-Lagares D, et al. Reduction rate by decompression as a treatment of odontogenic cysts [J]. Med Oral Patol Oral Cir Bucal, 2017, 22(5):e643-e650.
[22] Kubota Y, Imajo I, Itonaga R, et al. Effects of the patient's age and the size of the primary lesion on the speed of shrinkage after marsupialisation of keratocystic odontogenic tumours, dentigerous cysts, and radicular cysts [J]. Brit J Oral Max Surg, 2013, 51(4):358-362.
[23] Martin SA. Conventional endodontic therapy of upper central incisor combined with cyst decompression: a case report [J]. J Endod, 2007, 33(6):753-757.
[24] Balaji TS. Management of infected radicular cyst by surgical decompression[J]. J Conserv Dent, 2010, 13(3):159-161.
[25] Torres-Lagares D, Segura-Egea JJ, Rodriguez-Caballero A, et al. Treatment of a large maxillary cyst with marsupialization, decompression, surgical endodontic therapy and enucleation [J]. J Can Dent Assoc, 2011, 77:b87.
[26] 唐明娜,余萍萍,王艳,等.开窗减压术治疗乳牙根尖周囊肿临床病例分析[J].口腔医学研究,2014,28(8):795-796.
[27] Kün-Darbois JD, Pare A, Goga D, et al. In situ squamous cell carcinoma arising in a mandibular radicular cyst [J]. Eur Ann Otorhinolary, 2015, 132(5):305-306.