Objectives This case series aimed to assess the feasibility of a custom-made decompression
appliance fabricated using a digital workflow to decompress odontogenic cysts. Additionally,
the treated cysts were assessed for volumetric changes. Methods A three-dimensional
(3D) reconstruction software (CoDiagnostiX version 10.4) was used to obtain the master
cast STL (Standard Tessellation Language) file by placing a customized virtual implant
to create a recess for the tube of the decompression device. The decompression appliance
was planned using Dental Wings Open Software (DWOS). Following rapid prototyping,
the tube of the appliance was perforated using round burs. In cases where the appliances
were designed to replace teeth, denture teeth were added using the conventional workflow.
The appliances were delivered on the day of the cystostomy. Following decompression,
cyst enucleation was performed. Cyst volume was assessed by manual segmentation of
pre- and post-operative cone-beam computed tomography (CBCT) reconstructions using
slice-by-slice boundary drawing with a scissors tool in the 3DSlicer 4.10.2 software.
Percentage of volume reduction was calculated as follows: volume reduction/pre-operative
volume × 100. Results Six odontogenic cysts in six patients (5 male, 1 female; age
40 years, range: 15–49 years) with a pre- and post-operative cyst volume of 5597 ±
3983 mm3 and 2330 ± 1860 mm3 respectively (p < 0.05) were treated. Percentage of volume
reduction was 58.84 ± 13.22 % following a 6-month-long decompression period. Conclusions
The digital workflow described in this case series enables the delivery of decompression
appliances at the time of cystostomy, thus effectively reducing the volume of odontogenic
cysts. The resulting bone formation established a safe zone around the anatomical
landmarks; therefore, during enucleation surgery, complications to these landmarks
can be avoided.
