Surgical Technique for Conservative Management of Benign Lesions in Maxillofacial Region: Experience from a Single Clinic in Bogotá, Colombia

Abstract

Odontogenic tumors are lesions derived from the epithelium, the ectomesenchyme and/or the mesenchymal elements that were or continue to be part of the structures that forms the teeth. They are found exclusively within the maxillofacial skeleton and can occur at any stage of an individual's life. Keratocystic odontogenic tumors owe their name to their neoplastic behavior, aggressiveness, and high recurrence rate, which rates from 25 to 65%. Ameloblastomas, on the other hand, are benign, locally aggressive lesions, polymorphic neoplasms with proliferation of the odontogenic epithelium covering a fibrous stroma. Ameloblastomas have a high recurrence rate, about 60-80% if they are not adequately removed. The management of these injuries has become a challenge for the maxillofacial surgeon, currently there are two treatment alternatives, conservative management and surgical resection. A retrospective review of 7 cases of patients who consulted the maxillofacial surgery department of Clinica Universitaria Colombia was performed. 5 patients with a diagnosis of odontogenic keratocyst and 2 with a diagnosis of ameloblastoma treated with the technique proposed by Dr. Henry Aldana called “enucleation and corticotomies with a rotary instrument.” Technique that avoids block resection and allows taking advantage of the residual cavitation defect that, together with the mucoperiosteal closure, contains the initial clot to favor bone neoformation and allows spontaneous regeneration without the need for grafts or any other reconstructive technique. Patients have been followed up for a minimum period of 6 months and bone neoformation has been observed and the patients have no signs or symptoms related to recurrence of the lesion.