Descompressão e posterior enucleação de extenso cisto residual em mandíbula: relato de caso

Abstract

Residual cysts are cysts of inflammatory origin that remain in the jaw after the extraction of the tooth in which the radicular cyst originated. This study aims to present a clinical case of treatment of an extensive residual cyst in the mandibular body region, highlighting the clinical aspects, diagnostic management, and treatment through decompression with subsequent enucleation. The 54-year-old female patient, with melanoderma, was referred by another professional to the surgery clinic of the Faculty of Dentistry of the Federal University of Juiz de Fora for evaluation of a jaw injury. The diagnostic hypothesis until then would be ameloblastoma. However, after extensive anamnesis, the patient reported being under a previous tooth extraction in the region, which alerted them to the possibility of it being a residual cyst. A CBCT scan was then requested, which revealed an extensive radiolucent, unilocular area, with well-defined limits, involving the entire mandibular height, characteristic of a cystic lesion. From then on, the patient was alerted to the need to perform a biopsy to confirm the diagnosis and it was suggested that the device should be installed in the same surgical procedure to begin cystic decompression. After confirming the diagnosis of a residual cyst through biopsy, the patient remained under follow-up for 10 months for maximum reduction of the lesion until enucleation by curettage of the cystic lesion was performed. To conclude, there was a significant reduction in the extent of the injury following the decompression intervention, which allowed a safe and conservative enucleation surgery for the patient, with low chances of fracture of the mandibular bone cortex and recurrence.