Odontogenic keratocyst

Hello @btothetee. You had me at draconian…I’ve heard that word used more than once in my 3 decades in the dental field. 😉 I’m not a fan of being on the patient side of the chair either but we dental professionals really do try to minimize the draconian approach to treatment.

Because there can be several types of Odontogenic cysts, having a biopsy needs to be done to determine the composition. I’ve assisted in many biopsies over my career so maybe I can walk you through the basic procedure. You won’t have any view of this but from the dentist/assistant perspective this is generally the scenario…

Since the cyst is on your lower jaw, you’ll have a local anesthesia which will numb the entire side of the lower jaw where the surgery will be performed. This is the same anesthesia you’ve had for any other dental treatment where the jaw/tongue are numb on one side. (Or they may offer twilight sedation)
A small flap of tissue will be ‘opened’ with a scalpel to expose the bone. The dentist will trim away a small amount of bone to make a window to access the cyst. A sample of the cyst will be taken and then the flap stitched closed.

Your mouth will be tender in that area for a few days so you’ll need to eat soft foods and avoid vigorous brushing there. You’ll most likely be offered pain meds though often, Advil or Aleve will do the job. (Ice pack the first day)

The sample of the cyst will be sent to the lab for analysis to determine the type of cyst and further treatment. Or, considering you’re having this done at UCLA, they may have an onsite lab where this sample will be viewed right away and the oral surgeon may proceed with the removal of the cyst at that appointment.

I hope this helps you at least prepare for the appointment a bit. Have some ice packs ready, soup and softer foods. Will you please let me know how you’re doing after the surgery?

I definitely will @loribmt and thank you so much for this information… I was having a very difficult time…..understanding or getting details on the magnitude of the procedure. I knew that the doctor would have to get to the location through the bone… and this was what was freaking me out quite honestly. Thanks again so much and I’ll let you know how things turn out.

I don’t know why, but things that take place in our mouths just seem more invasive, don’t they? It’s perfectly understandable to get freaked out about this. It’s difficult to imagine what’s going to happen if you’ve never had the experince or seen it done. I’m glad I could bring a little relief to you about what you can most likely expect on Thursday. There may be some variations but the basic procedure should be about what I described for you.

Wishing you an easy time and again, I’m right here if you have any questions. 🙃

Good morning @btothetee, I just wanted to wish you well today. You’re in good hands with your dental team and they’ll walk you through this.
Try to relax and don’t forget your ice pack. ☺️

Hi @loribmt. Sorry getting back late. I had the biopsy and while they were inside my jaw they were able to remove most if not all the lesion. Still out for confirmation via biopsy of what it actually was/is. Some pain last night but mostly swelling. 26 sutures in mouth. Thanks again so much for your help. While the drilling into my jawbone wasn’t pleasant I didn’t feel anything. Thanks -B

Phew I’m so happy to hear from you! I’ve been thinking about you all day, hoping the surgery went well. I felt maybe they would remove what they could of the cyst while you were in surgery but didn’t want to speak out of turn just in case.
It’s wonderful you’re not too uncomfortable. That’s always a bit unpredictable but I thought I’d err on the side of caution and let you know the worst…so you were ready. 🙃 I’m happy it all went well and wish you all the best on the biopsy. Most of these cysts are benign so we’ll just keep that positive thought. 26 sutures took some might fancy stitching! Keep me posted!

@btothetee, just checking in. Did you get the results of the biopsy? How are you doing?

I started having neck gland soreness in January and my primary Doctor went through the usual treatment methods, but finally had a Head and Neck CT in May which identified a possible aneurysmal bone cyst. Was sent for an MRI in June which came back as possible, odontogenic keratocyst or ameloblastoma. Two days after a consult with Head & Neck at university hospital, I developed a "superinfection" and it landed me in two local ERs because of excessive swelling and pain. It was scary to see this morphing occur so quickly from a slight swelling in the left jaw to a "Fiona" look (Shrek-reference). Being a holiday weekend before the 4th of July did not make navigating easy, but I was directed to the ER at the university hospital and admitted. My blood pressure was really high 160s/120s probably due to the pain, but then it bottomed out at 75/38 while I was in the ER. So glad I made it there before that happened.

Two days later, this past Wednesday, I was in the OR for a biopsy and possible removal of the OKC. Unfortunately, that is not what happened. so now waiting for bone biopsy results and review of treatment plan for Thursday. I am scheduled for mandibular resection once I get through all of the appointments with the rest of the Head & Neck team. I watched the process of a resection, and bone grafting. It amazes me that this can be done! So, really hoping for a benign result this Thursday.

Hi @cmcail
I have had the mandible resection done two and a half years ago up at Mayo Rochester. If you have any questions or concerns please don’t hesitate to ask.
You have been through the mill already so hopefully this is the final battle.

I am here to be able to learn what to anticipate. Although I know each person's journey is uniquely their own, most of the challenges are the same. Thank you for reaching out.