.: ORİJİNAL ARAŞTIRMA
Management of Giant Odontogenic Cysts
Büyük Odontojenik Kistlerde Tedavi Yaklaşımı
Turkiye Klinikleri J Dental Sci. 2020;26(3):309-17
doi: 10.5336/dentalsci.2019-70701
Makale Dili: EN
Tam Metin
ABSTRACT
Objective: The purpose of this study is to determine the bony healing of giant odontogenic cysts which underwent conventional surgical operations without using any supplementary bone filling materials. Treatment of choice for large cysts depends on the size and location of the lesion (its approximity to vital structures), the patient's age and dention. Material and Methods: Twenty patients who were referred to Ege University School of Dentistry, Department of Oral and Maxillofacial Surgery between 1999 and 2010 for surgical operation of their giant cystic lesions were enrolled. All patients were treated under local anesthesia using standard materials and conventional surgical methods. None of the patients had bone resection as the treatment of choice and no bone filling biomaterials were utilized throughout the treatment. All cysts were subjected to histological examination after fixation in a 10% formalin solution. The final diagnoses after histological examination are reported. Results: Histological diagnoses of the giant cystic lesions revealed one radicular (5%), one residual (5%) and 18 dentigerous (90%) cysts of the jaws. The radiographic findings were analyzed in 24 months. During recall examinations, none of the patients showed postoperative complications and cystic lesions revealed considerable or complete bone healing. Conclusion: Rather than jaw resection, a well-planned conservative surgical approach following careful evaluation, meticulous treatment planning and close follow-up of patients may be preferred for treatment of giant cystic lesions.
Keywords: Odontogenic cyst; dentigerous cysts; curettage; bone regeneration
Objective: The purpose of this study is to determine the bony healing of giant odontogenic cysts which underwent conventional surgical operations without using any supplementary bone filling materials. Treatment of choice for large cysts depends on the size and location of the lesion (its approximity to vital structures), the patient's age and dention. Material and Methods: Twenty patients who were referred to Ege University School of Dentistry, Department of Oral and Maxillofacial Surgery between 1999 and 2010 for surgical operation of their giant cystic lesions were enrolled. All patients were treated under local anesthesia using standard materials and conventional surgical methods. None of the patients had bone resection as the treatment of choice and no bone filling biomaterials were utilized throughout the treatment. All cysts were subjected to histological examination after fixation in a 10% formalin solution. The final diagnoses after histological examination are reported. Results: Histological diagnoses of the giant cystic lesions revealed one radicular (5%), one residual (5%) and 18 dentigerous (90%) cysts of the jaws. The radiographic findings were analyzed in 24 months. During recall examinations, none of the patients showed postoperative complications and cystic lesions revealed considerable or complete bone healing. Conclusion: Rather than jaw resection, a well-planned conservative surgical approach following careful evaluation, meticulous treatment planning and close follow-up of patients may be preferred for treatment of giant cystic lesions.
Keywords: Odontogenic cyst; dentigerous cysts; curettage; bone regeneration
ÖZET
Amaç: Bu çalışmanın amacı, herhangi bir kemik greft materyali kullanılmadan konvansiyonel cerrahi operasyon ile tedavi edilmiş büyük odontojenik kistlerin kemik iyileşmesini belirlemektir. Geniş kistlerin tedavi seçenekleri kistin genişliğine, lokalizasyonuna, hastanın yaşına ve dentisyonuna göre değişmektedir. Gereç ve Yöntemler: 1999-2010 yılları arasında büyük odontojenik kistik lezyonlarının cerrahi operasyonu için Ege Üniversitesi Diş Hekimliği Fakültesi Ağız Diş ve Çene Cerrahisi Anabilim Dalı'na başvuran, aynı yöntem uygulanan 20 hasta çalışmaya alındı. Tüm hastalar lokal anestezi altında standart cerrahi yöntemler kullanılarak tedavi edildi. Hastalarda kemik rezeksiyonu uygulanmadı ve tedavi boyunca biyomateryal kullanılmadı. Tüm kistler %10'luk formalin çözeltisinde fiksasyon sonrası histolojik incelemeye tabi tutuldu. Histolojik inceleme sonrası kesin tanı bildirildi. Bulgular: Histolojik olarak bir radiküler (%5), bir rezidüel (%5) ve 18 dentijeröz (%90) kist tanısı koyuldu, 24 ay sonra radyolojik muayeneleri yapıldı. Kontrol muayeneleri sırasında hastalarda ameliyat sonrası komplikasyon görülmedi ve kistik lezyonlarda önemli derecede veya tam bir kemik iyileşmesi görüldü. Sonuç: Çene rezeksiyonu yerine, dikkatli değerlendirme, titiz tedavi planlaması ve hastaların yakın takibinden sonra iyi planlanmış konservatif cerrahi yaklaşım, büyük kistik lezyonların tedavisinde tercih edilebilir.
Anahtar Kelimeler: Odontojenik kist; dentijeröz kist; küretaj; kemik yenilenmesi
Amaç: Bu çalışmanın amacı, herhangi bir kemik greft materyali kullanılmadan konvansiyonel cerrahi operasyon ile tedavi edilmiş büyük odontojenik kistlerin kemik iyileşmesini belirlemektir. Geniş kistlerin tedavi seçenekleri kistin genişliğine, lokalizasyonuna, hastanın yaşına ve dentisyonuna göre değişmektedir. Gereç ve Yöntemler: 1999-2010 yılları arasında büyük odontojenik kistik lezyonlarının cerrahi operasyonu için Ege Üniversitesi Diş Hekimliği Fakültesi Ağız Diş ve Çene Cerrahisi Anabilim Dalı'na başvuran, aynı yöntem uygulanan 20 hasta çalışmaya alındı. Tüm hastalar lokal anestezi altında standart cerrahi yöntemler kullanılarak tedavi edildi. Hastalarda kemik rezeksiyonu uygulanmadı ve tedavi boyunca biyomateryal kullanılmadı. Tüm kistler %10'luk formalin çözeltisinde fiksasyon sonrası histolojik incelemeye tabi tutuldu. Histolojik inceleme sonrası kesin tanı bildirildi. Bulgular: Histolojik olarak bir radiküler (%5), bir rezidüel (%5) ve 18 dentijeröz (%90) kist tanısı koyuldu, 24 ay sonra radyolojik muayeneleri yapıldı. Kontrol muayeneleri sırasında hastalarda ameliyat sonrası komplikasyon görülmedi ve kistik lezyonlarda önemli derecede veya tam bir kemik iyileşmesi görüldü. Sonuç: Çene rezeksiyonu yerine, dikkatli değerlendirme, titiz tedavi planlaması ve hastaların yakın takibinden sonra iyi planlanmış konservatif cerrahi yaklaşım, büyük kistik lezyonların tedavisinde tercih edilebilir.
Anahtar Kelimeler: Odontojenik kist; dentijeröz kist; küretaj; kemik yenilenmesi
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