How to treat jaw cysts minimally invasively?

  Jaw cyst is a common and frequent disease in oral and maxillofacial surgery, which is difficult to attract patients’ attention because of its hidden location and usually no symptoms. When jaw bone cyst is found, the degree of bone destruction has been quite serious, and sometimes the cyst has grown very large, so the application of traditional scraping surgery will bring greater trauma to the patient, and may also damage the important neurovascular bundle, teeth, damage the maxillary sinus, loosen the teeth and become dead pulp teeth due to the removal of the root tip of the relevant teeth, cause postoperative infection, etc., and sometimes cause postoperative pathological fracture due to the reduction of local bone, which brings great pain to the patient. This can cause great pain and injury to the patient.  In recent years, the factors that cause the enlargement of jaw bone cysts have been studied thoroughly, and there are three main reasons: 1, caused by the proliferation of epithelium in the lining of the cyst; 2, increased osmotic pressure in the cyst, which makes the cyst grow expansively to the surrounding tissues; 3, certain substances in the cyst (prostaglandins, interleukin-1, lipids, enzymes, etc.) participate in the resorption of adjacent bone. In addition to these, the mechanical theory and the piezoelectric effect theory of orthodontics also explain the principle of cyst growth. Therefore, according to these theories cyst growth can be inhibited by eliminating or destroying the above mentioned factors.  Dr. Peng Chen’s group has achieved good results in the treatment of jaw cysts with the jaw cyst windowing therapy, which has been applied since many years ago.  According to the theory of orthodontic piezoelectric effect, the negative charge formed in the cyst after the opening of the window can induce the growth of osteoblasts and reduce the size of the cyst cavity; the cyst fluid is also aspirated during the operation, which eliminates the resorption of the adjacent bone involved in the cyst contents and makes the cyst cavity grow slowly. It makes the bone around the cyst cavity grow slowly thus achieving the purpose of shrinking and curing the cyst. At the same time, through the systemic anti-inflammatory, local flushing and drug exchange, iodoform gauze stuffing and other measures, it plays the role of anti-inflammatory and antiseptic, which is beneficial to the treatment of cysts.  After practical application, we believe that jaw cyst openings have the following advantages: 1. small surgical trauma; 2. little impact on the important structures existing around the cyst; 3. maximum protection of the teeth involved in the jaw cyst; 4. after jaw cyst openings, the jaw bone has a slow and natural bone repair process, and there is basically no significant change in volume before and after healing. Therefore, its ability to withstand external forces will not decrease either, and it will not have a functional impact on the oromandibular system.  Any method has its own limitations and drawbacks, and maxillary cystotomy is not suitable for all cysts. It has certain requirements in the selection of cases, which need to be decided by experienced doctors, and the need for multiple reviews after the patient is discharged from the hospital several days after surgery is also one of its drawbacks.