Cortical bone lamina approach for mandibular large cystic defect: a case report

This study evaluated the bone healing of the residual cavity after enucleation of mandibular inflammatory cyst by using only a coverage with cortical bone barrier. This study was conducted at the dental clinic of the Medical, Oral and Biotechnology Sciences Department of Chieti in February 2015. A 36-year-old male patient, D.G.M., had a mandibular inflammatory cyst (with a diameter of about 33.9x20.3mm) treated by surgical enucleation, subsequent apicectomy of the elements involved (4.1, 3.1, 3.2, 3.3, 3.4) and coverage of residual defect with a porcine cortical bone barrier (Bone Lamina). Postoperative clinical and radiographic examinations were performed at 3 and 9 months (panoramic radiographs) and at 12 and 24 months (CBCT Dental scan) respectively after cystic enucleation surgery. Uneventful healing and filling of the residual cavity was carried out. The computed analysis of the postoperative radiographs showed bone regeneration of cortical in terms of thickness increase at 12 and 24 months and showed mean values of reduction in size of the residual cavity of 92.1% after 12 months and 96.53% after 24 months. The volume of residual cavity (3123 mm3 in 2015) was seen to decrease (243.6mm3 at 12 months and 108.5 mm3 at 24 months). In this case report the Bone Lamina prevented tissue collapse within the defect and could maintain structural integrity throughout the period required for bone regeneration; it also has the advantage of resorbable membranes, avoiding a second surgery for its removal.