From the Research
The recommended treatment for a 1 cm x 1 cm nasopalatine duct cyst (NPDC) in the anterior maxilla is surgical enucleation through an intraoral approach. This procedure involves complete removal of the cyst along with its epithelial lining under local anesthesia. The surgery typically begins with a palatal flap elevation, followed by careful dissection of the cyst from surrounding structures, removal of the entire cyst, curettage of the cavity, and primary closure of the wound.
Key Considerations
- Prior to surgery, a thorough clinical and radiographic examination should be performed to confirm the diagnosis and rule out other pathologies 1.
- Postoperatively, patients should be prescribed analgesics such as ibuprofen 400-600 mg every 6-8 hours for pain management and chlorhexidine 0.12% mouthwash twice daily for 7-10 days to prevent infection.
- Antibiotics are generally not required unless there are signs of infection or the patient has specific risk factors.
- Follow-up appointments should be scheduled at one week for suture removal and then at 3-6 months to ensure complete healing and to monitor for recurrence.
Rationale
Surgical enucleation is considered the gold standard treatment because NPDCs are benign developmental cysts with very low recurrence rates (less than 2%) when completely removed, and this approach allows for histopathological examination to confirm the diagnosis 2, 3. The use of a custom-made surgical guide, as described in a recent study 1, can enhance the accuracy of the enucleation procedure.