Management of a solitary bone cyst using a custom-made surgical guide for a minimally invasive approach: technical note and case report.

BACKGROUND: Solitary Bone Cyst (SBC), also known as a simple bone cyst, hemorrhagic cyst, or traumatic cyst is classified by the WHO among non-odontogenic benign lesions of the jaw. The article explores the use of a static 3D-printed surgical guide to treat mandibular SBC, emphasizing a minimally surgical approach for this lesion. CASE PRESENTATION: A 20-year-old woman was referred for a persistent mandibular SBC lacuna, without specific complaints. Her medical history included a previous bone trepanation for a SBC in the same area, radiologically and surgically confirmed. X-ray assessment showed a well-defined unilocular radiolucency surrounding the root of the first left lower molar (tooth #36), measuring 10 × 10 mm. Pulp sensitivity was normal. CBCT data and STL files of dental cast were obtained preoperatively and registered. A 3D-printed surgical guide was used for minimally invasive trepanation of the buccal cortical. The simulation used a targeted endodontic microsurgery approach in order to determine axis and diameter of the trephine. Surgery was performed under local anesthesia. The guide was tooth supported integrating tubes and a fork for guiding precise trepanation. A 3.5 mm round bone window was created, leaving an empty cavity confirming SBC diagnosis and permitting bone curettage. A blood clot was obtained to promote bone healing. Complete reossification was observed after 6 months. The follow-up at 2 years confirmed a complete bone healing with normal pulp sensitivity. DISCUSSION: The 3D-printed windowed surgical guide with dental support offers big advantages, including improved visibility and reduced errors. Compared to traditional guides, it eliminates visual hindrance and allows easier and quick access to confined areas as well as an improved irrigation during drilling process. The article also highlights the importance of preoperative planning while acknowledging potential limitations and errors and surgical complications. CONCLUSION: The use of the 3D-printed surgical guide could be used in routine for minimally invasive intervention of SBC. This case also demonstrates the potential utility of this approach in various procedures in oral and maxillofacial surgery. The technique provides precise localization, reducing complications and enhances operative efficiency.

Medical infrared thermography in peri-operative management of peripheral ameloblastoma: A case report.

Peripheral ameloblastoma (PA) is a rare benign peripheral odontogenic tumor arising in the gingiva and in the overlying mucosa of tooth-bearing areas of the jaws. Recent data suggestthat the recurrence rate is directly related to inadequate surgical excision. This case of a 71-year-old man reports a poorly delineated mass effecting the gum of the left mandibular canine-premolars area histologically corresponded to PA. In complement to clinical visual examination of such a poorly delineated, non-exophytic and non-dyschromic inflammatory lesion, medical infrared thermography (MIT) - a non-invasive, non-ionizing and real-time imaging technique - was used to optimize the soft tissue margins, and a marginal bone resection was performed. MIT has also been found to be a useful tool in monitoring the absence of diseased tissue crossing the excisional margins at the end of the operation to minimize the risk of recurrence. After two years of follow-up, no local recurrence was found.