Liquid nitrogen cryosurgery and immediate bone grafting in the management of aggressive primary jaw lesions.
OBJECTIVE
This study evaluated whether simultaneous bone grafting will accelerate healing and reduce the complication rate of aggressive mandibular lesions treated by enucleation and liquid nitrogen cryotherapy.


METHODS
Twenty patients with locally aggressive mandibular lesions were evaluated. All were treated by enucleation and liquid nitrogen cryotherapy. Ten received simultaneous bone grafting and 10 did not. Patients were matched as closely as possible for age and size of lesion.


RESULTS
None of the patients who received enucleation, cryotherapy, and simultaneous bone grafting developed complications. Of the 10 patients having enucleation, cryotherapy, and no bone grafting, two patients developed pathologic fractures and one developed a wound dehiscence that healed on conservative management. Residual alveolar bone height was 81% of the preoperative level in the grafted group and 78% of the preoperative level in the nongrafted group. Additionally, 15 osseointegrated implants were placed in the group receiving bone grafting whereas none was placed in the group that was not grafted. All complications occurred with lesions greater than 4.0 cm in greatest diameter.


CONCLUSIONS
For locally aggressive lesions larger than 4.0 cm in greatest diameter, simultaneous cancellous bone grafting following enucleation and liquid nitrogen cryosurgery will decrease the risk of complications and result in greater residual bone height and a better ability to place endosseous dental implants.
Salmassy
D A
DA
Department of Oral and Maxillofacial Surgery, University of California, San Francisco 94143-0440, USA.
Pogrel
M A
MA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000564:Ameloblastoma / Q000601:surgery*; D016025:Bone Transplantation; D002648:Child; D003452:Cryosurgery / Q000009:adverse effects / Q000379:methods*; D003758:Dental Implantation, Endosseous; D005260:Female; D006801:Humans; D008297:Male; D008336:Mandibular Diseases / Q000601:surgery*; D008337:Mandibular Fractures / Q000209:etiology; D008339:Mandibular Neoplasms / Q000601:surgery*; D008875:Middle Aged; D009584:Nitrogen / Q000627:therapeutic use; D009807:Odontogenic Cysts / Q000601:surgery*; D013529:Surgical Wound Dehiscence / Q000209:etiology
D009584:Nitrogen