Injection
Only Sclerotherapy
for Mandibular Bone Cyst Without Surgery, as an Outpatient Treatment
What Are the Types of Mandibular Bone Cysts?
A Cyst is a
fluid-filled cavity, enclosed within a sac/capsule, arising in soft tissues or
bones. The common
type of Mandibular Bone Cyst is Odontogenic Cyst. Ondonto meaning tooth/teeth and
genic mean
arising/originating from. These cysts are formed or arise from the structures
that form the tooth/teeth. The common
type of Odontogenic Cyst is the Dentigerous Cyst. This
cyst usually contains a tooth within its cystic cavity. A Cyst that
has no tooth within it, is regarded as a Non-Dentigerous Cyst. All other Mandibular Bone Cysts are classified
as Non-Odontogenic Cysts,
arising from structures other than those related to tooth formation.
What is the Standard Treatment Method for Mandibular
Bone Cysts?
The standard
treatment method is either Marsupialization (create a pouch) or Enucleation (shell out).
Marsupialization means
surgically making a window and keeping it open with sutures, so that the
fluid may drain out into the oral cavity and eventually the cyst may shrink. Sometimes the
window will close up on its own & the cyst will not shrink. Enucleation means shelling out the entire cystic sac. However,
sometimes the sac is not well defined and it may be
difficult to shell out completely, giving rise to recurrences.
What Are the
Advantages of Injection Only Sclerotherapy for Madibular Bone Cysts?
Injection only
sclerotherapy is an
outpatient treatment allowing the patient to go home on the same day. The injection
(sclerosant) may
chemically destroy the cystic sac, induce scar tissue and bone formation over time,
thus shrink the cystic cavity for good. The overlying teeth may be preserved as
well, as a result of sclerosis compared to standard treatment methods. The injections
can simply be repeated until this effects (sclerosis) is achieved.
What Are the Complications of this Method?
Pain of injection and slight swelling for 3 days.
How is
Injection Only Sclerotherapy for Mandibular Bone Cysts Carried Out or Done?
Application of a spray or cream to
numb the overlying skin, followed by insertion of a large Intra-venous canula, into the
bony cavity through the
overlying skin. Keeping the canula in place, all the cystic fluid is drained and
replaced with the sclerosants. The patient is
reviewed and the procedure is repeated once a week for 3-4 sessions. Clinical
assessments and Plain Mandibular
X-Rays are done, before and after the procedures to assess the outcomes of this
treatment method
Indications for Injection Only Sclerotherapy:
Mandibular
Bony Cyst with a Single Cavity, With No Tooth and/or Calcifications Within the
Cystic Cavity and No Fistula (connection of
cystic cavity to the outside skin or oral mucosa) & the Bony shell must be easy
to pierce & canulate. The patient
must have no other medical conditions and must fully consent to the procedure
after thorough explanations of all
available treatment procedures and their advantages and disadvantages
*The
details of our technique will not be disclosed yet, until after publication
*Below
are diagrams of General Anatomy of a Subcutaneous Tissue Mass including a Cyst
&
The
Anatomy of a common Mandibular Bone Cyst
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