Pioneering the Use of MESNA in Oral and Maxillofacial Surgery: A double-blinded randomized controlled trial for Safe and Effective Dissection of Large Maxillary Odontogenic Cysts Encroaching Critical Structures.

Document Type : Consort randomized clinical trials (RCT)

Authors

1 faculty of dentistry Tanta university , egypt

2 Assistant professor, Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Tanta University, Tanta, Egypt

3 Oral & Maxillofacial Surgery Department, Faculty of Dentistry, Tanta University, Tanta 31527, Egypt.

Abstract

Aim: Despite decades of research, there is no information published on MESNA (Sodium 2-Mercaptoethanesulfonate) application in oral and maxillofacial surgery despite validity in other surgical specialties, we aimed to evaluate the safety and effectiveness of chemo-mechanical dissection using MESNA versus mechanical dissection in surgical excision of large maxillary odontogenic cysts encroaching critical structures.
Materials and methods: A prospective, randomized, double-blinded controlled trial was conducted among patients with large maxillary odontogenic cyst encroaching critical structures scheduled for enucleation and were randomized into: Group I (chemo-mechanical dissection with MESNA),or Group II (mechanical dissection with saline). Primary outcomes were differences in critical structures’ injury and intraoperative blood loss. Secondary outcomes included postoperative sensory nerve recovery assessment using a Visual Analogue Scale of 0 – 10,lesion dissection time and ease,wound healing, bone density, and histopathological correspondence.
Results: In total 16 patients were included.The incidence of sinus and nasal mucosa tears was significantly lower in Group I than in Group II. In group I, A lower mean intraoperative blood loss and lesion dissection time were reported than in group II. P-values were (0.003 and 0.004) respectively.In group I, early sensory nerve recovery scores were reported after 1 week and 3 weeks. In group I lower median lesion dissection easiness score was reported than in group II.No statistically significant differences were found in wound healing, 6 months’ bone density,or histopathological correspondence between both groups.
Conclusion: Chemo-mechanical dissection using MESNA safely and effectively preserves encroached critical structures, facilitates dissection, and minimizes complications in the surgical management of large maxillary odontogenic cysts.

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