A retrospective study of the effects of different surgical procedures on the mandibular nerve canal involved by odontogenic keratocyst

doi:10.7518/hxkq.2024.2024207

Abstract

Abstract:

Objective This study aims to evaluate the changes in the mandibular canal following the treatment of large odontogenic keratocysts through decompression and curettage, providing a theoretical basis for sequential treatment. Methods Twenty patients were selected for each decompression and curettage treatment of large odontogenic keratocysts in the mandible. Postoperative follow-up with was conducted every three months, during which cone beam computed tomography (CBCT) scans were performed. Then, the data were imported into MIMICS software to observe 3D changes in the position and structure of the mandibular nerve canal, followed by a comparative analysis. Results The total displacement of the mandibular canal was (1.89±0.21) mm on the decompression side and (0.80±0.19) mm on the curettage side. Vertically, the displacement range of the mandibular canal on the decompression side (M=1.03, SD=0.17) was larger than on the curettage side (M=0.52, SD=0.010) within nine months post-operation. In the buccal-lingual direction, the ratio of the thickness of the buccal plate to the lingual plate gradually increased with time. The amount of bone reconstruction at the part of the mandibular nerve canal closest to the cyst was (1.75±0.15) mm on the decompression side and (1.45±0.09) mm on the curettage side after nine months. Conclusion The mandibular nerve canal showed varying degrees of recovery and “relocation” after two surgical procedures. Osteogenesis around the mandibular nerve canal was more remarkable after decompression than after curettage. Therefore, for large odontogenic keratocyst, decompression is recommended as the initial treatment, followed by secondary curettage nine months later.

Key words: mandibular nerve canal, odontogenic keratocyst, decompression, curettage

CLC Number:

R782

Wang Zeyu, Du Chongli, Wang Dong, Peng Xiao, Du Yue, Wang Hanying, Gao Tingyi, Han Rui, Zhang Kai. A retrospective study of the effects of different surgical procedures on the mandibular nerve canal involved by odontogenic keratocyst[J]. West China Journal of Stomatology, 2025, 43(1): 106-113.

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项目	A组	B组	t或x²值	P值
性别/n			0.102	0.749
男	12	11
女	8	9
年龄/岁	30.60±10.94	38.9±18.82	157.5	0.249
囊肿最大径/cm	3.90±0.41	3.91±0.41	198.5	0.968

时间	A组/mm	B组/mm	置信区间（95%CI）	t值	P值
术后9个月总位移	1.03±0.17	0.52±0.10	0.52（0.37，0.67）	9.17	0.000 1
术后0~3个月位移	0.25±0.03	0.19±0.02	0.06（0.04，0.08）	8.74	0.000 1
术后3~6个月位移	0.54±0.08	0.23±0.07	0.31（0.26，0.36）	11.27	0.000 1
术后6~9个月位移	0.24±0.21	0.10±0.05	0.15（0.01，0.29）	2.37	0.039 0

H值	A组/mm	B组/mm	置信区间（95% CI）	t值	P值
手术前	0.86±0.05	0.82±0.07	0.03（0.01，0.08）	0.81	0.422 9
术后3个月	1.02±0.07	0.89±0.06	0.14（0.08，0.20）	5.06	0.000 1
术后6个月	1.27±0.10	0.93±0.05	0.34（0.28，0.36）	13.85	0.000 1
术后9个月	1.35±0.03	1.04±0.06	0.31（0.26，0.35）	15.40	0.000 1

时间		MC距囊肿距离/mm	t值	P值
术后3个月	A组	0.51±0.10	0.588	0.56
术后3个月	B组	0.43±0.09	0.588	0.56
术后6个月	A组	1.02±0.19	1.864	0.07
术后6个月	B组	0.74±0.16	1.864	0.07
术后9个月	A组	1.75±0.15	2.601	0.01
术后9个月	B组	1.45±0.09	2.601	0.01

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