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Successful removal of huge recurrent infected follicular cyst and reconstruction of lower jaw without any scars

15/2/2016

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A 28 year old man from Nigeria came to our hospital for expert treatment for his lower jaw defect. He gave the history of surgical removal of cystic lesion which was histopathologically diagnosed as follicular cyst in his lower jaw twice in his hometown and reconstructed with Bio-oss synthetic bone protein. Recurrence of the cystic lesion noted and the swelling was initially small and gradually increased to its present size for a period of 5 months. He was worried for the recurrence and wants to have permanent solution for the same.
Maxillofacial Surgeon Dr. S.M. Balaji performed the clinical and radiological investigations. OPG and 3D CT scan showed a large radiolucent lesion extending from the lower left first molar teeth till right first premolar region. Almost entire bone in this portion of the lower jaw was lost.
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Dr. Balaji successfully removed the cyst completely along with the affected teeth and bone. Rib graft was harvested and the used to reconstruct the jaw bone defect & the surgical site was closed. After subsequent healing, implants & ceramic crowns will be placed for fixed replacement of lost teeth.
Facial view showing swelling in the lower half of the face on the left side
Preoperative intraoral view showing huge swelling with cortical expansion and dislodged teeth in the affected region of mandible
3DCT scan view showing complete erosion of the buccal cortex and adjacent teeth root resorption due to cystic lesion
Preoperative digital orthopantomogram showing huge radiolucent lesion involving the symphysis and parasymphysis region of the mandible on the left side
Costochondral rib graft harvested to reconstruct the affected portion of mandible
Intraoperative view showing removal of the cyst along with the affected bone
Cystic lesion with affected teeth and bone removed in toto
Harvested rib graft used to reconstruct the defective portion of mandible
Immediately after suturing
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