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This article briefly reviews the clinical presentation and management of odontogenic cysts. A case is reported of an 18-year-old girl who, on 12-3-1986, presented for the first time at the Dental Department, University of Nairobi with a painful bony swelling in the chin area. The extensive swelling apparently arose long after the traditional removal of two mandibular incisors. After periodontal prophylaxis the cystic lesion was enucleated under a local anaesthetic and the cavity lining subjected to histopathological examination which revealed appearances consistent with those of an odontogenic residual cyst. Immediate wound care involved dressing the defect with zinc iodoform paste on ribbon gauze for 4 weeks when complete granulation and epithelialisation occurred. Subsequently the patient was instructed on homecare irrigation of the cavity without packing. Clinical and radiographic assessment showed progressively satisfactory healing of both the soft tissue and bone through a follow-up period of about two years. It is suggested that the cavity filling in process by periosteal and endosteal bone deposition may be faster where the defect is left without a pack or obturator following complete granulation and epithelialisation.

Comparative study of treatment of keratocysts by enucleation, enucleation combined with cryotherapy or treatment with Carnoy's solution followed by enucleation: a preliminary report. The aim of this preliminary report was to compare the effect on the recurrence rate of keratocysts treated by enucleation (group E, 14 cysts), enucleation combined with cryotherapy (group EK, 14 cysts) or a fixing agent (Carnoy's solution) followed by enucleation (group CE, 10 cysts). A total of 32 patients with 38 keratocysts are included in the study. In group E 5 recurrences (36%) was developed after 17, 34, 36, 37 and 39 months postoperatively, whereas 5 recurrences (36%) after 22, 24, 24, 25 and 59 months was registered in group EK. Due to a rather high incidence of side effects to cryotherapy this treatment technique can not be recommended. No recurrences has been found in group CE, and usually complete bone healing has occurred after 6 to 12 months postoperatively. Due to the use of the strong fixing agent we recommend treatment by this method performed under general anaesthesia to secure an immobile surgical field. In accordance with recent studies, the results indicate that fixation before enucleation has revolutionized the art of treating keratocysts with respect to recurrence rate.

Demineralized bone matrix has been tested in a clinical study concerning the filling of bone defects in the surgical stomatology. It is reported on the clinical results and the X-ray evaluation of the replacement of bones by demineralized bone matrix. Fifty two implantations in the maxilla and mandible of 51 patients were carried out to be able to evaluate the efficacy of demineralized bone matrix.

Transfixation after Wirz, a closed implantation, serves to conserve periodontally weakened teeth. The method can be recommended to the practitioner. It is subdivised into 6 phases which are described. The treatment method may be successfully enlarged clinically and topographically. 7 cases are demonstrated and show the scope of indication.

This report illustrates a conservative approach in the treatment of keratocysts involving the lower left canine in a case of nevoid basal cell carcinoma syndrome in a 10-year-old boy during 6 years' follow-up. The purpose of this report was to state the view of conservatism in the treatment of selected cases of keratocysts, based on close cooperation of the patient, orthodontist and oral surgeon. In this case, there are several keratocysts in both upper and lower jaws. Only the keratocysts associated with the lower left canine is considered to be conservatively treated in the presented case.

The aim of the study was to investigate the recurrence rate of keratocysts based on a material with a follow-up of at least 5 years, and to evaluate the relationship between different features of these cysts and their recurrence. It was found that of 75 keratocysts with follow-up times ranging from 5 to 17 years (mean 8.3), 32 (43%) recurred. The cumulative recurrence rate of the 67 annually examined cysts increased from 3% after the 1st year following the operation to 37% after the 3rd year. Thereafter, no new recurrences were noted. Recurrence of keratocysts in patients with basal cell nevus syndrome occurred more frequently than that of patients without the syndrome. Keratocysts enucleated in one piece recurred significantly less often than cysts enucleated in several pieces. The recurrence rate of keratocysts with a clinically observable infection, with fistula or with a perforated bony wall was higher than that of keratocysts without these features. Recurrence was also found more frequently in cysts with multilocular radiographic appearance than in unilocular cysts. The size or the location of the keratocysts did not have an influence on the recurrence rate.