J Korean Assoc Oral Maxillofac Surg.  2015 Aug;41(4):208-212. 10.5125/jkaoms.2015.41.4.208.

Enucleation of large keratocystic odontogenic tumor at mandible via unilateral sagittal split osteotomy: a report of three cases

Affiliations
  • 1Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea. ssh8080@pusan.ac.kr

Abstract

Keratocystic odontogenic tumor (KCOT) is a common benign tumor of osseous lesions in dental and maxillofacial practice. We describe three cases of large KCOT located in the posterior part of the mandible extending to the angle and ramus region, which were enucleated via sagittal split osteotomy (SSO) of the mandible. There are cases in which a conventional enucleation procedure does not ensure complete excision of the entire lesion without damage to vital structures like the inferior alveolar nerve. In such cases, a SSO approach could be a better choice than conventional methods. The purpose of this article is to describe our experience using unilateral mandibular SSO for removal of a KCOT from the mandible.

Keyword

Sagittal split ramus osteotomy; Cysts; Keratocystic odontogenic tumor

MeSH Terms

Mandible*
Mandibular Nerve
Odontogenic Cysts*
Odontogenic Tumors*
Osteotomy*
Osteotomy, Sagittal Split Ramus

Figure

  • Fig. 1 Preoperative panoramic radiograph of case 1.

  • Fig. 2 Intraoperative findings of case 1. A. Exposure and preservation of inferior alveolar nerve using sagittal split osteotomy approach. B. Fixation with miniplate.

  • Fig. 3 Left side enucleated mass with teeth of case 1.

  • Fig. 4 Postoperative panoramic radiograph of case 1 (7-month follow-up).

  • Fig. 5 Preoperative panoramic radiography of case 2.

  • Fig. 6 Postoperative panoramic radiography of case 2 (5-month follow-up).

  • Fig. 7 Preoperative cone-beam computed tomography of case 2 (#37 tooth).

  • Fig. 8 Postoperative cone-beam computed tomography of case 2 (#37 tooth) (5-month follow-up).

  • Fig. 9 Preoperative panoramic radiograph of case 3.

  • Fig. 10 Postoperative panoramic radiograph of case 3 (5-month follow-up).


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