# Different Approaches to the Treatment of Radicular and Related Cysts Associated with Nasal Mucosa in the Maxilla: A Case Series

## TL;DR

This case series explores surgical treatments for maxillary cysts near nasal and sinus areas, showing successful outcomes with multimodal approaches.

## Contribution

The study introduces a structured anatomical stratification system and multimodal treatment protocols for complex maxillary cysts.

## Key findings

- Seven patients showed favorable clinical and radiographic outcomes with no fistula formation or recurrence.
- Multimodal strategies combining enucleation and regenerative techniques proved effective in complex anatomical cases.

## Abstract

Radicular cysts (RCs) represent the most frequent inflammatory cystic lesions of the jaw, typically arising from non-vital teeth. While standard management via enucleation is well-documented, complex cases involving the anterior maxilla present significant surgical challenges due to their proximity to the nasal cavity floor (NCF) and the maxillary sinus floor (MSF). This report provides a comprehensive revision of a clinical case series involving seven patients (ages 17–50) treated with multimodal surgical and regenerative protocols. The patients were stratified into five distinct anatomical risk groups (A–E) based on the integrity of the bony boundaries and the presence of oronasal communications. The treatment strategies combined meticulous cyst enucleation with advanced regenerative techniques, including platelet-rich fibrin (PRF), allogeneic and xenograft bone substitutes, and local flaps such as the buccal fat pad (BFP). The results across all seven cases demonstrated favorable clinical and radiographic outcomes, with no instances of oronasal fistula formation or recurrence during follow-up periods ranging from 12 months to three years. This report emphasizes the necessity of structured anatomical stratification and multimodal planning to ensure scientific precision and surgical predictability in the management of complex maxillary lesions. The differences between approaches towards the nasal cavity and maxillary sinus have to be highlighted. Further studies with larger cohorts are warranted to evaluate the long-term outcomes of different treatment modalities.