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Odontogenic keratocysts are significant cysts of the jaw that are characterized by aggressive behavior and a high tendency to recur. The treatments of choice may be radical or conservative, and in the literature a debate is still open about the gold standard in the treatment of OKCs.This report describes a wide multilocular OKC extended in the right mandibular ramus and illustrates atypical behavior of a cystic lobe after marsupialization, not found to our knowledge in the previous literature. Moreover, an orthognathic procedure, consisting of sagittal osteotomy was chosen for the excision of the cyst to preserve as much bone as possible and the integrity of the inferior alveolar nerve.

Mural ameloblastoma is a subtype of Unicystic Ameloblastoma characterised by the expansion or infiltration of tumour nodules into the fibrous wall of the cyst. The behaviour of this subtype is highly aggressive, with a risk of recurrence comparable with that of Conventional Ameloblastoma. Consequently, the preferred treatment for Unicystic mural Ameloblastom is broad resection of the tumour. In this case report we describe the successful conservative treatment of a Unicystic mural Ameloblastom associated with an impacted tooth. The conservative treatment consinsted in a initial marsupialization followed by the enucleation of the lesion performed with a lateral corticotomy to create a “bone door” and the relocation of the “bone door” using microplates and titanium screws. Our conservative approach preserved the integrity of the inferior alveolar nerve as well as mandibular functionality and resulted in a good aesthetic outcome. Due to the behaviour of this lesion, a strict follow up is mandatory. In our experience, follow-up is conducted as long as possible regardless of the surgical treatment. This protocol includes Cone Beam CT performed 1 year after surgery and panoramic radiology (OPG) once a year until 5 years after surgery. OPG is then repeated every 3 years in patients with Unicystic Ameloblastoma and every 2 years in those with Conventional Ameloblastoma or ameloblastoma with mural invasion. Suspected recurrence should be evaluated by CBCT.

Marsupialization, designed to reduce the mandibular cyst volume, has continued to debated regarding its influence on the healing of the related bone cavity. The aim of the present study was to evaluate the 3-dimensional radiographic variation over time in mandibular odontogenic cystic lesions after marsupialization and assess the correlations between these variations and variables that can affect the procedure.We planned a retrospective cohort study. The predictor variables were the treatment duration, preoperative volume, patient age, histologic type, and number of preoperative residual bony walls. The outcomes variables were the postoperative volume reduction and the daily reduction rate calculated using computed tomography (CT) from before to after marsupialization using software designed for volumetric reconstruction and measurement of cyst-related bone defects. The descriptive and bivariate statistics were computerized, and the significance level was set at P = .05.The sample included 15 patients (12 men and 3 women; mean age, 51.6; range, 27 to 85 years) affected by keratocysts (n = 6), dentigerous cysts (n = 6), and radicular cysts (n = 3) who had undergone marsupialization. The median duration of marsupialization was 406 days (25th to 75th percentile, 276 to 519). The mean ± standard deviation (SD) pre- and postdecompression volumes were 6,908.27 ± 2,669.058 and 2,468.13 ± 1,343.517 mmMarsupialization appears useful in improving the healing of cyst-related bone defects in mandibles, especially larger defects. Further studies with a wider sample size would add more knowledge to this topic.

The paper examines 91 cases of iliac crest bone samples used in maxillofacial surgery for different purposes and evaluates the immediate and later complications which arise in the site of origin. The most frequent immediate complications are walking difficulties, hematoma, and sensitivity disturbances. Later complications usually include: esthetic deficits (depression of the crestal surface), walking difficulties, and a persistent neurological deficit. The complications observed substantially match those reported in the literature.

A homogeneous group of 30 patients who were operated over a 5-year period for odontogenic sinusitis using a buccosinusal communication following Caldwell-Luc's technique were studied. A marked discrepancy between the conventional X-ray picture and the clinical picture emerged from these 30 case studies. So as to find an explanation for this discrepancy, all patients underwent CAT tests. On the basis of a critical evaluation of the results obtained it is suggested that patients be followed using a postoperative instrumental control protocol.