Çocuklardaki farklı odontojenik kistlerin yalnızca akrilik aparey kullanılarak yapılan dekompresyonla tedavisi: uzun dönemli klinik çalışma

Year 2023, Volume: 28 Issue: 1, 15 - 23, 20.01.2023

Enes Özkan , Bilal Özmen

https://doi.org/10.21673/anadoluklin.1202049

Abstract

Amaç: Çocukluk çağında çene kemiklerinde nadir olarak radiküler kist, dentigeröz kist ve odontojenik keratokist gibi odontojenik kistler meydana gelebilir. Bu tür kistlerin tedavisi, konservatif yaklaşımlardan radikal cerrahi prosedürlere kadar farklı şekillerde yapılabilir. Bu çalışmanın amacı, çocuklarda çeşitli odontojenik kistlerin tedavisi için akrilik obturator kullanılarak yapılan dekompresyon yönteminin uzun dönemli başarısını değerlendirmektedir.

Yöntemler: 2014-2016 yılları arasında pedodonti kliniğine başvuran pediatrik hastalar çalışmaya dâhil edildi. Yaş, cinsiyet, anatomik yerleşim, başvuru nedenleri, kistlerin histopatolojik tanıları ve boyutları, ilişkili olduğu dişler gibi veriler kaydedildi. Odontojenik kistler akrilik obturatör ile dekompresyon yöntemi kullanılarak tedavi edildi. Tüm hastalar operasyondan bir, üç, altı ve 12 ay sonra ve sonrasında yıllık olarak, klinik ve radyolojik inceleme ile değerlendirildi.

Bulgular: Patolojik inceleme sonucunda toplam 16 odontojenik kistin 10’u dentigeröz kist, 5’i radiküler kist ve 1’i odontojenik keratokist olduğu tespit edilmiştir. Çalışmaya dâhil edilen hastalar 4 kız ve 12 erkekten oluşmaktadır ve ortalama yaşları 108,86±21,01 aydır. Dekompresyon tedavisinin ortalama süresi 7.3±1,41 aydır. Hastalar ortalama olarak 9,6±2,56 yıl takip edildi. Dört hastada gömük daimi dişlerin spontan sürmesi gözlenmedi, bunlar ortodontik tedavi ile sürdürüldü. İki dentigeröz kist vakasında gömülü dişler çekildi ve kist enükle edildi. Kalan 14 vakada daimi dişler (spontan+ortodontik) başarıyla sürdü (%87,5) ve dekompresyon tedavisi sonrası kistler tamamen iyileşti.

Sonuç: Çocuklarda odontojenik kistlerin tedavisinde gelişimsel problemlerden kaçınmak için konservatif prosedürler tercih edilmelidir. Akrilik obtüratör kullanılarak yapılan dekompresyon tedavisi, pediatrik hastalarda odontojenik kistler için etkili bir tedavidir ve bu yaklaşım kistlerin spontan olarak iyileşmesinin yanısıra daimi dişlerin başarılı bir şekilde sürmesini de sağlayabilir. Ancak bu sonuçların desteklenmesi için daha geniş örneklem boyutlarına sahip yeni klinik çalışmaların yapılmasına ihtiyaç bulunmaktadır.

Keywords

Aparey;, çocuk;, dekompresyon;, dentijeröz kist;, radiküler kist, keratokist

The treatment of different odontogenic cysts in children only using acrylic appliance-guided decompression: A long-term clinical study

Abstract

Aim: Various odontogenic cysts may rarely occur in the jawbones during childhood, including radicular cysts, dentigerous cysts, and odontogenic keratocysts. Treatment for such cysts ranges from conservative approaches to radical surgical procedures. The present study evaluates the effect of the decompression alone method for treating various odontogenic cysts in children.

Methods: A retrospective cohort study was performed that included pediatric patients who applied to the pedodontics clinic between 2014 and 2016. Data such as age, gender, anatomical location, reasons for admission, histopathological diagnosis and dimensions of the cysts, and associated teeth were recorded. All odontogenic cysts were treated using the decompression method with an acrylic obturator. All patients were evaluated clinically and radiologically one, three, six, and 12 months after the operation and annually thereafter.

Results: As a result of the pathological examination, it was determined that 10 of the 16 odontogenic cysts were dentigerous cysts, 5 were radicular cysts and 1 was an odontogenic keratocyst. The patients consisted of 4 girls and 12 boys, with a mean age of 108.68±21.01 months. The average duration of the decompression was 7.3±1.41 months and the average follow-up was 9.6±2,56 years. In four patients, spontaneous eruption of the impacted permanent teeth was not observed; these were erupted using orthodontic treatment. In two cases of dentigerous cysts, the impacted teeth were extracted and the cyst was enucleated. In the remaining 14 cases, the permanent teeth erupted (spontaneous+orthodontic guided) successfully (87.5%), and the cysts healed completely after decompression treatment.

Conclusion: To avoid developmental problems, conservative procedures should be preferred for the treatment of odontogenic cysts in children. Decompression therapy using an acrylic obturator is an effective treatment for odontogenic cysts in pediatric patients; this approach protects and maintains permanent teeth. However, new clinical studies with larger sample sizes are needed to support these results.

Keywords

Appliance;, child;, decompression;, dentigerous cyst, radicular cyst, odontogenic keratocyst

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