Decompression Tube Fixation on Adjacent Teeth for Cystic Lesions in the Jaws: A Long-Term Follow-Up Analysis of Predictive Factors.

Introduction Decompression is an effective conservative treatment for large odontogenic cysts; however, conventional tube stabilization often encounters issues such as device dislodgement or mucosal trauma. This study aimed to analyze the therapeutic efficacy and clinical outcomes of a novel decompression tube fixation method secured directly to adjacent teeth using stainless steel wire. Materials and methods We retrospectively reviewed 20 patients (11 males, 9 females; mean age: 41.5 years) with jaw cysts treated between 2013 and 2023. Quantification of cyst dimensions and two-dimensional (2D) lesion area reduction rates (RR) was performed using panoramic radiographs and NIH Image software (National Institutes of Health, Bethesda, USA). The impact of clinical parameters - including lesion location, tube parameters (central vs. marginal placement), and a history of infection - on therapeutic efficacy was statistically analyzed. Results The cohort comprised radicular cysts (n=8, 40.0%), dentigerous cysts (n=7, 35.0%), odontogenic keratocysts (n=4, 20.0%), and a simple bone cyst (n=1, 5.0%). Outcomes were categorized as extremely effective (n=9, 45.0%), moderately effective (n=5, 25.0%), and poorly effective (n=6, 30.0%). Lesions in the mandibular body and maxilla achieved optimal results, whereas mandibular ramus lesions showed poorer responses. This location-dependent efficacy created an apparent trend toward better outcomes in elderly males, which was confounded by the predominance of ramus cases in younger females (<44 years). Centrally placed tubes (n=12, 60.0%) yielded more consistent treatment outcomes than marginally placed tubes(n=8, 40.0%), potentially due to a lower susceptibility to lumen occlusion by surrounding granulation tissue. A history of infection was associated with a lower RR. The mean decompression period was 17.6 months. A longitudinal analysis of individual patient data revealed distinct reduction trajectories at the six-month mark; patients with a >50% area RR at six months achieved a higher success rate (6/7 cases, 85.7%) compared to those with <50% reduction (6/13 cases, 46.1%) Conclusions Our method of decompression tube fixation onto adjacent teeth is a reliable, well-tolerated, and effective modality, even for older patients and large odontogenic cystic lesions. A six-month evaluation threshold (50% reduction) serves as an adequate clinical indicator for determining whether to continue decompression therapy or proceed to early definitive surgical enucleation.