Cystectomy surgery: retrospective epidemiological study, a ten-year experience

BACKGROUND: The aim of this study is to analyze the epidemiological features and determine the frequency of different types of cyst of the jaw diagnosed at the Maxillofacial and Odontostomatology Clinic of the Maggiore Hospital in Trieste (Italy).

MATERIALS AND METHODS: A retrospective observational study was performed on 238 patients, 117 treated as out-patients and 121 that underwent surgery in the operating room.

RESULTS: The mean major diameter of the lesions removed under local anesthesia was significantly lower than those removed under general anesthesia (14.3 ±5.01 mm and 23.7 ± 11.3 mm, respectively, p <0.05). Complications occurred in 19,7% of all cases. Paresthesia of the third branch of the trigeminal nerve was the most common complication observed, more than a half of those cases show a complete remission in the first year of follow-up. The positive association was underscored with the simultaneous extraction of one or more impacted teeth.

CONCLUSIONS: The incidence of this pathologic condition is probably underestimated because of its scarce symptomatology; however, in the advanced stages cysts could become a clinical issue. Surgical procedure can be performed under local anesthesia or general anesthesia. In the latter option a greater surgical difficulty (given primarily by the size of the lesions) and greater morbidity was reported highlighting the need of greater surgical skills beyond the competence of a non-specialist dentist.

CLINICAL SIGNIFICANCE: This study highlights the importance of early detection and appropriate management of jaw cysts. Smaller cystic lesions can often be treated under local anesthesia with minimal risk, while larger lesions typically require general anesthesia and carry higher perioperative and postoperative complications, including inferior alveolar nerve paresthesia. Awareness of these risks enables oral surgeons to plan treatment more effectively, minimize nerve injury, and provide optimal patient care. Early intervention may reduce lesion size, simplify surgery, and improve long-term outcomes.

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