Assessment Of Spontaneous Bone Healing Following Cyst Enucleation With Computerized Tomography

Yıl 2008, Cilt: 2 Sayı: 2, 75 - 81, 01.03.2008

Sevil A Kahraman Serap Demirtaş Gültekin Şule Yücetaş Sedat Çetiner

Öz

Purpose: This study was planned to evaluate spontaneous bone regeneration after removal of large odontogenic cysts. Material and methods: Fourteen patients with odontogenic cysts larger than 3 cm in diameter were selected for this study. Odontogenic cysts were treated by enucleation and primary closure. CT scans were taken postoperatively on the tenth day and in the third, sixth and twelfth months to measure residual cavity volume. Initial and remaining cavity volumes were compared on CT images. Means and standard deviations were calculated for all variables.Results: A progressive reduction in the volume of the cavities was apparent. Findings for the newly formed tissue in the third, sixth and twelfth postoperative months were also increased. Results of this study suggest that using grafts doesn’t contribute to increased bone regeneration and large cyst defects can regenerate spontaneously

Anahtar Kelimeler

spontaneous regeneration, odontogenic cyst, bone healing

Kistlerin Enükleasyonları Sonrası Spontan Kemik İyileşmesinin Bilgisayarlı Tomografi ile Değerlendirilmesi

Öz

Amaç: Bu çalışmada büyük odontojenik kistlerin çıkartılmasını takiben kemik iyileşmesinin değerlendirilmesi planlanmıştır. Gereç ve yöntem: Üç cm’den büyük çapa sahip odontojenik kisti bulunan 14 hasta çalışmaya dahil edilmiş olup, kistlerin enükleasyonları sonrası primer kapama ile tedavi tamamlanmıştır. Postoperatif onuncu gün, üçüncü ay, altıncı ay ve onikinci aylarda bilgisayarlı tomografi ile rezidüel kavite hacminin ölçümü gerçekleştirilmiştir. Rezidüel kavite hacmi, ilk hacimle karşılaştırılmıştır. Elde edilen tüm ölçümlerin ortalama ve standart deviasyonları gruplar içinde hesaplanmıştır. Bulgular: Tüm hastalarda, kavite hacimlerinde zaman içinde belirgin azalma gözlenmiştir. Çalışmanın sonuçları, büyük kist kavitelerinin spontan olarak rejenere olabileceğini göstermektedir

Anahtar Kelimeler

odontojenik kist, kemik iyileşmesi, spontan kemik rejenerasyonu

Kaynakça

• Peterson L.J.: Principles of Oral and Maxillofacial Surgery. Lippincott-Raven Publishers, 1997.
• Yücetaş Ş.: Ağız ve Çevre Dokusu Hastalıkları. Atlas Kitapçılık, Ankara, 2005.
• Soames J.V., Southam J.C.: Oral Pathology. Oxford University Press. Third Edition, 1998.
• Günhan Ö.: Oral ve Maksillofasiyal Patoloji.Atlas Kitapçılık Tc. Ltd. Şti., 1. Baskı, 2001.
• Türker M, Yücetaş Ş.: Ağız, Diş, Çene Hastalıkları ve Cerrahisi. Özyurt Matbaacılık, 3. Baskı, Ankara, 2004.
• Enislidis G., Fock N., Sulzbacher I., Ewers R.: Conservative Treatment of Large Cystic Lesions of the Mandible: A Prospective Study of the Effect of Decompression. British Journal of Oral and Maxillofacial Surgery, 42:546- 550, 2004.
• Jung Y, Lee S, Park H.: Decompression of large odontogenic keratocysts of the mandible. J. Oral and Maxfac. Surg. 63:267-271, 2005.
• Bodner L.: Effect of Decalcified Freeze,Dried Bone Allograft on the Healing of Jaw Defects After Cyst Enucleation. J. Oral and Maxillofacial Surgery, 54:1282-1286, 1996.
• Nakamura N., Mitsuyasu T., Mitsuyasu Y., Taketomi T., Higuchi Y., Ohishi M.: Marsupialization for Odontogenic Keratocysts: Long-term Follow-up Analysis of the Effects and Changes in Growth Characteristics. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 94:543-553, 2002.
• Bodner L., Bar-ZIv J., Kaffe I.: Ct of Cystic Jaw Lesions. J Comput Assist Tomogr, 18:22-25, 1994.
• Nergis Ceydeli Radyolojik Görüntüleme Tekniği, Merit Medikal Teknolojler LTD, 2000.
• Santamaria J., Garcia A.M., Vicente J.C., Landa S., Lopez-Arranz J.S.: Bone Regeneration After Radicular Cyst Removal with and without Guided Bone Regeneration. Int. J. Oral Maxillofac Surg. 27:118-120, 1998.
• Etzias A., Sugar W.: Pathological fractures of the mandible: A diagnostic and treatment dilemma. Br J Oral Maxillofac Surg 32:303, 1994.
• Chiapasko M., Rossi A., Motta J. J., Crescentini M.: Spontaneous Bone Regeneration After Enucleation of Large Mandibular Cysts: A Radiographic Computed Analysis of 27 Consecutive Cases. J. Oral Maxillofac. Surg. 58:942-948, 2000.
• Moy P.K., Lundgren S., Holmes R.E.: Maxillary sinus augmentation: Histomorphometric analysis of graft materials for maxillary sinus floor augmentation. J Oral Maxillofac Surg 51:857, 1993.
• Mitchell R.: An evaluation of bone healing in cavities in the jaws implanted with a collagen matrix. Br J Oral Maxillofac Surg 30:180-182, 1992.
• Akal K.A., Cambazaoğlu M. : Kistektomi, Kronik Enfeksiyon Bölgelerinin Küretajı ve Apikal Rezeksiyon Operasyonları Sonucunda Oluşan Kemik Defektlerinde Solventlerle Dehidrate Edilmiş Spongioz Kemik Çipslerinin Kullanılması, A.Ü. Diş Hek. Fak. Derg. 22(2):103-108, 1995.
• Aslan M, ŞimŞek G, DayI E.: Guided Bone Regeneration (GBR) on Healing Bone Defects: A Histological Study in Rabbits. J Contemp Dent Pract 5(2):114-123, 2004.
• Bodner L.: Osseous regeneration in the jaws using demineralized allogenic bone implants. J Craniomaxillofac Surg 26:116-120, 1998.
• Costantinides J., Zachariades N.: Homogenous bone grafts to the mandible. J Oral Surg 36:599, 1978.
• Dahlin C, Sandberg E, AlberIus P, Linde A: Restoration of Mandibular Nonunion Bone Defects: An experimental Study in Rats Using an Osteopromotive Membrane Method. Int J Oral Maxillofac Surg 23: 237, 1994.
• Ducheyne P., Schepers E.J.G.: The application of bioactive glass particles of narrow size range as a filler material for bone lesions: A 24 month animal experiment. Bioceramics 6:401, 1993.
• Getter L, Bhaskar Sn, Cutright D.E., et al: Three biodegradable calcium phospate slurry implants in bone. J Oral Surg 30:263, 1972.
• Guglielmotti M. B., Alonso C., Itoiz M. E. , Cabrinis R. L. : Increased Osteogenesis in Alveolar Wound Healing Elicited by Demineralized Bone Powder. J Oral Maxiilofac Surg, 48: 487-490, 1990.
• Horowitz I., Bodner L.: Use of xenograft bone with