Turkiye Klinikleri Journal of Dental Sciences

.: ORIGINAL RESEARCH
Management of Giant Odontogenic Cysts
Büyük Odontojenik Kistlerde Tedavi Yaklaşımı
Aylin SİPAHİ ÇALIŞa, Hüseyin KOCAa, Pelin GÜNERİb, Candan EFEOĞLUa
aDepartment of Oral Surgery, Ege University Faculty of Dentistry, İzmir, TURKEY
bDepartment of Oral and Maxillofacial Radiology, Ege University Faculty of Dentistry, İzmir, TURKEY
Turkiye Klinikleri J Dental Sci. 2020;26(3):309-17
doi: 10.5336/dentalsci.2019-70701
Article Language: EN
Full Text
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
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
REFERENCES:
  1. Underbrink M, Pou A, Quinn, Jr FB, Ryan MW. Odontogenic cysts and tumors. Grand Rounds Presentation, UTMB, Dept. of Otolaryngology. February 13, 2002. http://www.utmb.edu/otoref/grnds/Odontogenic-tumor_2002-02/Odontogenic-Tumors-2002-02.htm, downloaded on 12 Dec 2011.
  2. Shear M, Speight PM. Cysts of the Oral and Maxillofacial Regions. 4th ed. Singapore: Blackwell Munksgaard; 2007. p.228. [Crossref] 
  3. Prockt AP, Schebela CR, Maito FDM, Sant'Ana-Filho M, Rados PV. Odontogenic cysts: analysis of 680 cases in Brazil. Head Neck Pathol. 2008;2(3):150-6. [Crossref]  [PubMed]  [PMC] 
  4. Nu-ez-Urrutia S, Figueiredo R, Gay-Escoda C. Retrospective clinicopathological study of 418 odontogenic cysts. Med Oral Patol Oral Cir Bucal. 2010;15(5):e767-73. [Crossref]  [PubMed] 
  5. Larsen PE, Hegtvedt AK. Odontogonesis and odontogenic cysts and tumors. In: Cummings CW, ed. Otolaryngology Head and Neck Surgery. 2nd ed. Vol 2. St. Louis: Mosby Year Book; 1993. 3-17.
  6. Driemel O, Rieder J, Morsczeck C, Schwarz S, Hakim SG, Müller-Richter U, et al. [Comparison of clinical immunhistochemical findings in keratocystic odontogenic tumours and ameloblastomas considering their risk of recurrence]. Mund Kiefer Gesichtschir. 2007;11(4):221-31. [Crossref]  [PubMed] 
  7. Grossmann SM, Machado VC, Xavier GM, Moura MD, Gomez RS, Aguiar MCF, et al. Demographic profile of odontogenic and selected nonodontogenic cysts in a Brazilian population. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;104(6):e35-41. [Crossref]  [PubMed] 
  8. Eichhorn W, Wehrmann M, Blessmann M, Pohlenz P, Blake F, Schmelzle R, et al. Metastases in odontogenic cysts: literature review and case presentation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109(4):582-6. [Crossref]  [PubMed] 
  9. Aziz SR, Pulse C, Dourmas MA, Roser SM. Inferior alveolar nerve paresthesia associated with a mandibular dentigerous cyst. J Oral Maxillofac Surg. 2002;60(4):457-9. [Crossref]  [PubMed] 
  10. Koseoglu BG, Atalay B, Erdem MA. Odontogenic cysts: a clinical study of 90 cases. J Oral Sci. 2004;46(4):253-7. [Crossref]  [PubMed] 
  11. Edamatsu M, Kumamoto H, Ooya K, Echigo S. Apoptosis-related factors in the epithelial components of dental follicles and dentigerous cysts associated with impacted third molars of the mandible. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;99(1):17-23. [Crossref]  [PubMed] 
  12. Ustuner E, Fitoz S, Atasoy C, Erden I, Akyar S. Bilateral maxillary dentigerous cysts: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;95(5):632-5. [Crossref]  [PubMed] 
  13. Tournas AS, Tewfik AM, Chauvin PJ, Manoukian JJ. Multiple unilateral maxillary dentigerous cysts in a non-syndromic patient: a case report and review of the literature. Int J Pediatr Otorhinolaryngol Extra. 2006;1(2):100-6. [Crossref] 
  14. Akyol UK, Salman IA. A case of an extensive dentigerous cyst in the maxillary sinus leading to epiphora and nasal obstruction. J Emerg Med. 2012;43(6):1004-7. [Crossref]  [PubMed] 
  15. Passi S, Gauba K, Agnihotri A, Sharma R. Dentigerous cyst in primary dentition: a case report. J Indian Soc Pedod Prev Dent. 2008;26(4):168-70. [Crossref]  [PubMed] 
  16. Avitia S, Hamilton JS, Osborne RF. Dentigerous cyst presenting as orbital proptosis. Ear Nose Throat J. 2007;86(1):23-4. [Crossref]  [PubMed] 
  17. Litvin M, Caprice D, Infranco L. Dentigerous cyst of the maxilla with impacted tooth displaced into orbital rim and floor. Ear Nose Throat J. 2008;87(3):160-2. [Crossref]  [PubMed] 
  18. Roberts MW, Barton NW, Constantopoulos G, Butler DP, Donahue AH. Occurrence of multiple dentigerous cysts in a patient with the Maroteaux-Lamy syndrome (mucopolysaccharidosis, type VI). Oral Surg Oral Med Oral Pathol. 1984;58(2):169-75. [Crossref]  [PubMed] 
  19. Dağistan S, Cakur B, Göregen M. A dentigerous cyst containing an ectopic canine tooth below the floor of the maxillary sinus: a case report. J Oral Sci. 2007;49(3):249-52. [Crossref]  [PubMed] 
  20. Prabhakar V, Sandhu SV. Nonsyndromic bilateral maxillary dentigerous cysts: review of literature and report of an unusual case. Int J Pediatr Otorhinolaryngol Extra. 2011;6(1):5-8. [Crossref] 
  21. Bodner L, Bar-Ziv J. Characteristics of bone formation following marsupialization of jaw cysts. Dentomaxillofac Radiol. 1998;27(3):166-71. [Crossref]  [PubMed] 
  22. Kirtaniya BC, Sachdev V, Singla A, Sharma AK. Marsupialization: a conservative approach for treating dentigerous cyst in children in the mixed dentition. J Indian Soc Pedod Prev Dent. 2010;28(3):203-8. [Crossref]  [PubMed] 
  23. Elo JA, Slater LJ, Herford AS, Tanaka WK, King BJ, Moretta CM. Squamous cell carcinoma radiographically resembling a dentigerous cyst: report of a case. J Oral Maxillofac Surg. 2007;65(12):2559-62. [Crossref]  [PubMed] 
  24. Litonjua LA, Aguirre A, Estrada MCL. Radiolucency in the mandible. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;98(5):511-5. [Crossref]  [PubMed] 
  25. Wang CC, Kok SH, Hou LT, Yang PJ, Lee JJ, Cheng SJ, et al. Ectopic mandibular third molar in the ramus region: report of a case and literature review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105(2):155-61. [Crossref]  [PubMed] 
  26. Saia G, Fusetti S, Emanuelli E, Ferronato G, Procopio O. Intraoral endoscopic enucleation of a solitary bone cyst of the mandibular condyle. Int J Oral Maxillofac Surg. 2012;41(3):317-20. [Crossref]  [PubMed] 
  27. Yüzügüllü B, Araz K. Validity of conventional surgical treatment methods for mandibular dentigerous cysts. Two case reports. N Y State Dent J. 2011;77(2):36-9. [PubMed] 
  28. Tekkesin MS, Olgac V, Aksakalli N, Alatli C. Odontogenic and nonodontogenic cysts in Istanbul: analysis of 5088 cases. Head Neck. 2012;34(6):852-5. [Crossref]  [PubMed] 
  29. Açikgöz A, Uzun-Bulut E, Özden B, Gündüz K. Prevalence and distribution of odontogenic and nonodontogenic cysts in a Turkish population. Med Oral Patol Oral Cir Bucal. 2012;17(1):e108-15. [Crossref]  [PubMed]  [PMC] 
  30. Janicki P, Boeuf S, Steck E, Egermann M, Kasten P, Richter W. Prediction of in vivo bone forming potency of bone marrow-derived human mesenchymal stem cells. Eur Cell Mater. 2011;21:488-507. [Crossref]  [PubMed] 

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