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@#Dentigerous cyst is the most common odontogenic development cyst. If the cyst reaches a large size (>2 cm in diameter), swelling, mild sensitivity, tooth mobility, and displacement may be observed. The classic treatment for dentigerous cysts is enucleation and extraction of the involved tooth. This case report presents follicular cyst of unerupted permanent tooth. Case Report: 11-year-old girl, radiographic examination showed a radiolucent area from the mandibular right first premolar to mandibular deciduous second molar. Intraorally there was expansion of the buccal cortex to 85, 44th tooth. The mucosa over the expansion was normal. On palpation was no tender. Due to the age of the patient and cyst size, enucleation of the lesion is decided. Under local anesthesia following strict aseptic conditions, a full thickness mucoperiosteal flap was raised, an ostectomy on the crestal bone was performed. The cyst was enucleated along with extraction of mandibular deciduous second molar. The flaps were placed in its original position and sutured. Cyst was sent for histopathological examination. The follow-up was performed periodically under radiographic examinations during 8 months and it was observed successful regeneration of bone.
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El tratamiento endodóntico-quirúrgico en dientes con quistes inflamatorios radiculares es un desafío clínico debido a su complejidad, y más aún si están en piezas con anomalías de desarrollo dental, como lo es la geminación dentaria. A continuación se presenta un caso clínico en el que se logra la reparación de una lesión apical mediante una necropulpectomía de la pieza geminada y enucleación del quiste adyacente.
The surgical-endodontic treatment of teeth with an inflammatory radicular cyst is a clinical challenge due to its great complexity. Even more so, if they are in teeth with development anomalies such as gemination. The case below shows the repair of an apical lesion by a necro-pulpectomy of the geminated tooth and the enucleation of the adjacent cyst.
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Humanos , Masculino , Adulto , Dientes Fusionados/cirugía , Dientes Fusionados/complicaciones , Quiste Radicular/cirugía , Quiste Radicular/complicaciones , PulpectomíaRESUMEN
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Ameloblastoma , Legrado , Órgano del Esmalte , Asimetría Facial , Mandíbula , Diente Molar , Tercer Molar , Quistes Odontogénicos , Fenobarbital , Recurrencia , Diente , Diente ImpactadoRESUMEN
INTRODUCTION: Bone regeneration of cystic defects of the jaws after a cyst treatment requires lengthy healing periods. Generally, the bony changes are observed periodically through a visual radiographic reading as well as by the clinical opinion and radiographic images (panorama, periapical view), but it is difficult to compare the objective bony changes using only the radiographic density. In addition, it is difficult to observe minute bony changes through a visual radiographic reading, which can lead to a subjective judgment. This study exmined the bone density after the enucleation of a jaw cyst by fractal analysis. MATERIALS AND METHODS: Eighteen patients with a cystic lesion on the jaw were assessed. Panoramic radiographs were taken preoperatively, immediately postoperatively, and 1, 3, 6 and 12 months after cyst enucleation. The images were analyzed by fractal analysis. RESULTS: The mean fractal dimensions increased immediately after surgery and 3, 6 and 12 months postoperatively. The postoperative 6 and 12 months fractal dimension was similar to the controls. CONCLUSION: Fractal analysis was used to overcome the limit of a subjective reading during an assessment of bone regeneration after cyst enucleation.
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Humanos , Densidad Ósea , Regeneración Ósea , Fractales , Maxilares , Quistes Maxilomandibulares , JuicioRESUMEN
INTRODUCTION: Bone defects in the jaw are frequently observed after odontogenic cyst enucleation. The success of bone healing appears to be related to the size of the bone defect, the anatomical location, the patient's age and other parameters. The use of bone grafting material is dependent on the operator's preference. No evidence-based definite treatment protocol has been established. This study evaluated the effect of a bone graft into the defect after odontogenic cyst enucleation. MATERIALS AND METHODS: A total of 55 patients, who had been treated for an odontogenic cyst with cyst enucleation from 2000 to 2009 at the department of Oral and Maxillofacial Surgery, Samsung Medical Center, were included in this study. Patients who were followed-up for more than 1 year were included. Two groups were defined according to the bone graft (with or without a bone graft) after cyst enucleation. The differences in the healing periods and patterns of bone healing were compared clinically and radiologically. The postoperative 1 year radiographs were analyzed for bone healing and density. Statistical analysis was performed using a Pearson chi square test and Wilcoxon rank-sum test. RESULTS: More infection signs were observed in the bone graft group than in the other group, but there was no statistically significant difference. Radiographically, there was also no significant difference in the size of the radiolucent lesions between the two groups. CONCLUSION: There was no significant difference in healing between the groups with a bone graft and without bone graft after cyst enucleation.
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Humanos , Trasplante Óseo , Protocolos Clínicos , Maxilares , Quistes Odontogénicos , Cirugía Bucal , TrasplantesRESUMEN
OBJECTIVE: The purpose of this study was to determine whether cyst enucleation would be done after marsupialization of large cystic lesion on the jaws or not, and if so, when it should be done. PATIENTS & METHODS: 12 patients with cystic lesion treated by marsupialization only and 10 patients with cystic lesion treated by marsupialization followed by enucleation were examined in this study. Postoperative clinical and radiographic examinations were performed at 1, 4, 7, 10, 13, 16, 19 months on 22 patients. Bone regeneration and reduction rate of the residual cystic cavities and bone density were evaluated with a analysis of digital panoramic radiographs. Also histological evaluation of the healing process was performed on 1 patient. RESULTS: Uneventful healing and spontaneous bony filling of the residual cavities were observed in all cases. Postoperative radiographs showed that the size of the lesions was reduced for a few months, but the reduction rate of the residual cavity was minimized for 13~16 months after marsupialization. The bone density was increased 22.5 % after 19 months. CONCLUSION: This results suggest that the appropriate timing to perform enucleation would be 13~16 months after marsupialization. The state of healing process could be confirmed by histological examination and radiographic evaluation of bone density. Enucleation after marsupialization could be applied appropriately to reduce the periods of bone healing in large cystic lesion on the jaws.
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Humanos , Densidad Ósea , Regeneración Ósea , MaxilaresRESUMEN
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Humanos , Densidad Ósea , Regeneración Ósea , Estudios de Seguimiento , Maxilares , Quistes Maxilomandibulares , Mandíbula , Maxilar , TrasplantesRESUMEN