A conservative management of an extensive odontogenic residual cyst: a case report

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.