Treatment of Cystic and Tumoral Lesions

Table of Contents

Treatment of cystic and tumoral lesions involves the removal or control of benign (non-cancerous) and malignant (cancerous) lesions in the mouth and jaw area through surgical and medical methods. The treatment approach is determined based on the type, size, location, and histopathological characteristics of the lesion, as well as the patient’s general health status.

Treatment of cystic and tumoral lesions requires a multidisciplinary approach. The size and type of the lesion, and the patient’s general health should be considered in treatment planning. Early diagnosis is the most important factor increasing treatment success. Therefore, regular dental check-ups and radiological follow-up are of great importance.

Treatment of Cystic Lesions

Cysts are pathological cavities usually filled with fluid or semi-fluid material and surrounded by an epithelial membrane. Common cystic lesions in the mouth and jaw area include radicular cysts, dentigerous cysts, odontogenic keratocysts, and periodontal cysts.

Surgical Methods

Enucleation

It is the process of completely removing the cyst. Local or general anesthesia is administered. Access to the cyst is provided by lifting the mucoperiosteal flap. The cyst is excised without damaging the surrounding tissues. The area is closed with stitches after the operation.

Advantages: Ensures complete removal of the cyst. The recurrence rate is low.
Disadvantages: Large cysts can damage surrounding anatomical structures.

Marsupialization

It is the process of emptying the contents of the cyst and joining its walls with the oral mucosa. A window is opened in the cyst wall. The contents of the cyst are emptied, and the area is washed with sterile solutions. The opened window is sutured to the oral mucosa.

Advantages: Prevents bone resorption in large cysts. Causes less damage to surrounding tissues.
Disadvantages: There is a risk of recurrence. The healing period is long.

Combined Method

Marsupialization is applied first, followed by enucleation. Preferred for large cysts.

Supportive Treatments

If the cyst is infected, antibiotic treatment can be applied before and after surgery.
Irrigation with sterile solutions is performed.
Radiographic follow-up is done.

Treatment of Tumoral Lesions

Tumors can be benign or malignant. Treatment planning is done according to the size, spread, and histological features of the tumor.

Treatment of Benign Tumors

Surgical Excision: Benign tumors are usually surgically removed along with surrounding tissues.
Curettage: Applied in small and limited lesions. It is removed by scraping the surrounding bone or soft tissues.
Reconstructive Surgery: Defects that occur after excision in large tumors are repaired with reconstructive surgery. Autogenous grafts or implants can be used.

Types of Benign Tumors

Ameloblastoma: Usually a wide excision is performed.
Osteoma: Seen in the jawbone and removed by local excision.
Fibroma: It is a soft tissue lesion and is usually excised.

Treatment of Malignant Tumors

Treatment of malignant tumors requires a multidisciplinary approach. The most common malignant tumor among oral cancers is squamous cell carcinoma.

Surgical Excision: The primary tumor and surrounding healthy tissues are removed. Wide resection is performed (e.g., mandibulectomy or maxillectomy). Lymph node dissection may be required.
Radiotherapy: Applied after or before surgery to reduce tumor size and prevent recurrence. Controls the spread of malignant tumors.
Chemotherapy: It is a part of systemic cancer treatment. It is generally applied in cases where the risk of metastasis is high.
Combined Treatment: Surgery, radiotherapy and chemotherapy can be used together. For example, the tumor is first surgically removed, followed by radiotherapy.

Post-Treatment Management

Reconstruction: Reconstructive surgery may be required to eliminate aesthetic and functional losses after major surgical procedures. Autogenous bone grafts, soft tissue grafts, and dental implants are used in these procedures.
Regular Follow-up: Regular clinical and radiological follow-up is required for both benign and malignant lesions.
Rehabilitation: Regaining chewing and speech functions. Making prosthesis or implant-supported restorations.

Modern Techniques Used in Treatment

Piezo Surgery: Used for precise removal of bone tissues.

Laser Surgery: Used for minimally invasive removal of soft tissues. Provides bleeding control and speeds up the healing process.

Navigation-Assisted Surgery: Especially used in complex tumor resections. Provides high accuracy.