MANDİBULAR DENTİJERÖZ KİSTLERİN KONİK IŞINLI BİLGİSAYARLI TOMOGRAFİ GÖRÜNTÜLEME ÖZELLİKLERİ VE KEMİK EKSPANSİYONU İLE İLİŞKİLİ OLABİLECEK GÖRÜNTÜLEME ÖZELLİKLERİ

Year 2023, , 323 - 331, 24.10.2023

Gökçen Akçiçek , Leyla Berna Çağırankaya , Nursel Akkaya , Hatice Yağmur Zengin

https://doi.org/10.26650/JARHS2023-1221508

Abstract

Amaç: Dentijeröz kist (DK), çenelerde sık görülen kistlerden biri olup teşhis edilmesinde radyografik özellikleri önem taşımaktadır. Bu çalışmanın amacı mandibular DK’lerin konik ışınlı bilgisayarlı tomografi (KIBT) görüntüleme özelliklerini incelemek ve kemik ekspansiyonu ile görüntüleme özellikleri arasındaki olası ilişkileri değerlendirmektir.
Gereç ve Yöntem: Çalışmaya KIBT görüntüsü olan ve patoloji raporu ile tanısı doğrulanan hastalar dahil edilmiştir. KIBT görüntülerinde lezyonun radyografik özelliklerinin yanı sıra, gömülü dişin pozisyonu ve kist-kron ilişkisi de değerlendirilmiştir.
Bulgular: 36 DK’nin %69,4’ünün gömülü dişi etkilediği (%61,1 yer değişikliği, %5,6 rezorpsiyon ve %2,8 yer değişikliği ve rezorpsiyon), %80,6’sının ekspansiyona neden olduğu, %100’ünün kortikal tabakalarda tutuluma neden olduğu (perforasyon ve incelme), %80,6’sının inferior alveolar kanalı etkilediği (%13,9 rezorpsiyon, %11,1 yer değişikliği, %55,6 rezorpsiyon ve yer değişikliği), %65,7’sinin komşu dişi etkilediği (%27,8 rezorpsiyon, %30,6 lamina dura kaybı, %5,6 yer değişikliği ve lamina dura kaybı), gömülü dişlerin %25’inin bukkal/lingual oblik pozisyonda olduğu ve %55,5’inde lateral tip kist-kron ilişkisi olduğu tespit edildi. Ekspansiyon oranı ile gömülü dişe etki (p=0,023) ve komşu dişe etki (p=0,011) arasında istatistiksel olarak anlamlı ilişki saptandı. Ayrıca kist-kron ilişkisi ile gömülü dişin bukkolingual konumu arasında da istatistiksel olarak anlamlı ilişki gözlendi (p=0,031).
Sonuç: Bu çalışmada gömülü dişte rezorpsiyon ve yer değişikliği ile komşu dişte yer değişikliği ve lamina dura kaybının sık olduğu ve bunların DK’lerin ekspansiyon oranı ile istatistiksel olarak ilişkili olduğu bulundu. Bu bulgular ekspansiyonun belirtisi olabileceğinden dikkatlice değerlendirilmelidir.

Keywords

Konik ışınlı bilgisayarlı tomografi, dentijeröz kist, mandibula

CONE BEAM COMPUTED TOMOGRAPHY IMAGING CHARACTERISTICS OF MANDIBULAR DENTIGEROUS CYSTS AND POSSIBLE IMAGING FEATURES ASSOCIATED WITH BONE EXPANSION

Abstract

Objective: Dentigerous cysts (DC) are one of the most common cysts in the jaw, and radiographic features are important for diagnosis. This study aims to evaluate the radiographic features of mandibular DCs on cone beam computed tomography (CBCT) images and investigate the possible associations between the imaging features and bone expansion.
Material and Methods: Patients who had CBCT images with pathologically proven DC within the mandible were included the study. On CBCT images, besides lesion radiographic features, the position of the impacted tooth and cyst-to-crown relationship were also recorded.
Results: Among 36 DCs, 69.4% affected the impacted tooth (61.1% were displaced, 5.6% were resorbed and 2.8% were both displaced and resorbed), 80.6% expanded, 100% had cortical involvement (perforation and thinning), 80.6% affected the inferior alveolar canal (%13.9 resorption, %11.1 displacement, 55.6% resorption and displacement), 65.7% affected the adjacent teeth (27.8% resorption, 30.6% lamina dura loss, 5.6% displacement and lamina dura loss), 25% of impacted tooth position were in buccal/lingual obliquity, and 55.5% had a lateral type cyst-to-crown relationship. There was a statistically significant relationship between the expansion rate and effect on the impacted tooth (p=0.023), between the expansion rate and effect on the adjacent tooth (p=0.011), and between the cyst-to-crown relationship and impacted tooth buccolingual position (p=0.031).
Conclusion: Resorption and displacement of the impacted tooth and resorption, displacement and lamina dura loss of the adjacent tooth were common and statistically related with DCs expansion rates. These imaging features could be a sign of expansion and should be carefully examined.

Keywords

Cone beam computed tomography, dentigerous cyst, mandible

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