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

Yıl 2023, Cilt: 28 Sayı: 1, 15 - 23, 20.01.2023
https://doi.org/10.21673/anadoluklin.1202049

Öz

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.

Kaynakça

  • Bodner L. Cystic lesions of the jaws in children. Int J Pediatr Otorhinolaryngol. 2002;62(1):25–9.
  • Nagata T, Nomura J, Matsumura Y, et al. Radicular cyst in a deciduous tooth: a case report and literature review. J Dent Child. 2008;75:80-4.
  • Mass E, Kaplan I, Hirshberg A. A clinical and histopathological study of radicular cysts associated with primary molars. J Oral Pathol Med. 1995;24:458-61.
  • Penumatsa NV, Nallanchakrava S, Muppa R, Dandempally A, Panthula P. Conservative approach in the management of radicular cyst in a child: case report. Case Rep Dent. 2013;2013:123148.
  • Taysi M, Ozden C, Cankaya AB, Yildirim S, Bilgic L. Conservative approach to a large dentigerous cyst in an 11-year-old patient. J Istanb Univ Fac Dent. 2016;50:51-56.
  • Kirtaniya BC, Sachdev V, Singla A, Sharma AK. Marsupialization: a conservative approach for treating dentigerous cysts in children in the mixed dentition. J Indian Soc Pedod Prev Dent. 2010;28:203-8.
  • Delbem AC, Cunha RF, Afonso RL, Bianco KG, Idem AP. Dentigerous cysts in primary dentition: Report of 2 cases. Pediatr Dent. 2006;28:269-72.
  • Deboni MC, Brozoski MA, Traina AA, Acay RR, Naclério-Homem Mda G. Surgical management of dentigerous cyst and keratocystic odontogenic tumor in children: a conservative approach and 7-year follow-up. J Appl Oral Sci. 2012;20:282-5.
  • Bhardwaj B, Sharma S, Chitlangia P, Agarwal P, Bhamboo A, Rastogi K. Mandibular Dentigerous Cyst in a 10-Year-Old Child. Int J Clin Pediatr Dent. 2016;9:281-4.
  • Kalaskar RR, Tiku A, Damle SG. Dentigerous cysts of anterior maxilla in a young child: a case report. J Indian Soc Pedod Prev Dent. 2007;25:187-90.
  • Morankar R, Bhatia SK, Goyal A, Gulia P. Conservative management of keratocystic odontogenic tumour in a young child with decompression and an intraoral appliance: 5-year follow-up. BMJ Case Rep. 2018;2018:bcr2017221563.
  • Zecha JA, Mendes RA, Lindeboom VB, et al. Recurrence rate of keratocystic odontogenic tumor after conservative surgical treatment without adjunctive therapies - A 35-year single institution experience - A 35-year single institution experience. Oral Oncol. 2010;46:740–2.
  • Alnofaie H, Alomran O, Ababtain R, Alomar A. Spontaneous Eruption of a Deeply Impacted Premolar After Conservative Treatment of an Associated Dentigerous Cyst: A Case Report. Cureus. 2019;11:e6414.
  • Castro-Núñez J. An Innovative Decompression Device to Treat Odontogenic Cysts. J Craniofac Surg. 2016;27:1316.
  • Berti Sde A, Pompermayer AB, Couto Souza PH, Tanaka OM, Westphalen VP, Westphalen FH. Spontaneous eruption of a canine after marsupialization of an infected dentigerous cyst. Am J Orthod Dentofacial Orthop. 2010;137:690-3.
  • Harokopakis-Hajishengallis E. Physiologic root resorption in primary teeth: molecular and histological events. J Oral Sci. 2007;49:1-12.
  • Boot AM, de Ridder MA, Pols HA, Krenning EP, de Muinck Keizer-Schrama SM. Bone Mineral Density in Children and Adolescents: Relation to Puberty, Calcium Intake, and Physical Activity. J Clin Endocrinol Metab 1997;82:57–62.
  • Gandhi S, Franklin DL. Presentation of a radicular cyst associated with a primary molar. Eur Arch Paediatr Dent 2008;9:56–9.
  • Moturi K, Puvvada D, Kotha PR. A Novel, Minimally Invasive Technique in the Management of a Large Cyst Involving the Maxilla in a Child: A Case Report. Cureus. 2018;10:e2503.
  • Nawaz MS, Yazdanie N, Faheemuddin M. Rehabilitation of a cystic mixed dentition mandible following marsupialization with a multipurpose acrylic splint acting as a space maintainer and an obturator. J Ayub Med Coll Abbottabad. 2011;23:177-9.
  • Kolokythas A, Fernandes RP, Pazoki A, et al. Odontogenic keratocyst: to decompress or not to decompress? A comparative study of decompression and enucleation versus resection/peripheral ostectomy. J Oral Maxillofac Surg 2007;65:640–4.
  • Uloopi KS, Shivaji RU, Vinay C, Pavitra, Shrutha SP, Chandrasekhar R. Conservative management of large radicular cysts associated with non-vital primary teeth: a case series and literature review. J Indian Soc Pedod Prev Dent. 2015;33:53-6.
  • Koca H, Esin A, Aycan K. Outcome of dentigerous cysts treated with marsupialization. J Clin Pediatr Dent. 2009;34:165-8.
  • Jones AV, Franklin CD. An analysis of oral and maxillofacial pathology found in children over a 30-year period. Int J Paediatr Dent. 2006;16:19-30.
  • Narang RS, Manchanda AS, Arora P, Randhawa K. Dentigerous cyst of inflammatory origin-a diagnostic dilemma. Ann Diagn Pathol. 2012;16:119-23.
  • Gültelkin SE, Tokman B, Türkseven MR. A review of paediatric oral biopsies in Turkey. Int Dent J. 2003;53:26-32.
  • Ramakrishna Y, Verma D. Radicular cyst associated with a deciduous molar: A case report with unusual clinical presentation. J Indian Soc Pedod Prev Dent. 2006;24:158-60.
  • Shibata Y, Asaumi J, Yanagi Y, et al. Radiographic examination of dentigerous cysts in the transitional dentition. Dentomaxillofac Radiol. 2004;33:17-20.
  • Ozturk G, Dogan S, Gumus H, Soylu E, Sezer AB, Yilmaz S. Consequences of Decompression Treatment With a Special-Made Appliance of Nonsyndromic Odontogenic Cysts in Children. J Oral Maxillofac Surg. 2022;80(7):1223-37.

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

Yıl 2023, Cilt: 28 Sayı: 1, 15 - 23, 20.01.2023
https://doi.org/10.21673/anadoluklin.1202049

Öz

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.

Kaynakça

  • Bodner L. Cystic lesions of the jaws in children. Int J Pediatr Otorhinolaryngol. 2002;62(1):25–9.
  • Nagata T, Nomura J, Matsumura Y, et al. Radicular cyst in a deciduous tooth: a case report and literature review. J Dent Child. 2008;75:80-4.
  • Mass E, Kaplan I, Hirshberg A. A clinical and histopathological study of radicular cysts associated with primary molars. J Oral Pathol Med. 1995;24:458-61.
  • Penumatsa NV, Nallanchakrava S, Muppa R, Dandempally A, Panthula P. Conservative approach in the management of radicular cyst in a child: case report. Case Rep Dent. 2013;2013:123148.
  • Taysi M, Ozden C, Cankaya AB, Yildirim S, Bilgic L. Conservative approach to a large dentigerous cyst in an 11-year-old patient. J Istanb Univ Fac Dent. 2016;50:51-56.
  • Kirtaniya BC, Sachdev V, Singla A, Sharma AK. Marsupialization: a conservative approach for treating dentigerous cysts in children in the mixed dentition. J Indian Soc Pedod Prev Dent. 2010;28:203-8.
  • Delbem AC, Cunha RF, Afonso RL, Bianco KG, Idem AP. Dentigerous cysts in primary dentition: Report of 2 cases. Pediatr Dent. 2006;28:269-72.
  • Deboni MC, Brozoski MA, Traina AA, Acay RR, Naclério-Homem Mda G. Surgical management of dentigerous cyst and keratocystic odontogenic tumor in children: a conservative approach and 7-year follow-up. J Appl Oral Sci. 2012;20:282-5.
  • Bhardwaj B, Sharma S, Chitlangia P, Agarwal P, Bhamboo A, Rastogi K. Mandibular Dentigerous Cyst in a 10-Year-Old Child. Int J Clin Pediatr Dent. 2016;9:281-4.
  • Kalaskar RR, Tiku A, Damle SG. Dentigerous cysts of anterior maxilla in a young child: a case report. J Indian Soc Pedod Prev Dent. 2007;25:187-90.
  • Morankar R, Bhatia SK, Goyal A, Gulia P. Conservative management of keratocystic odontogenic tumour in a young child with decompression and an intraoral appliance: 5-year follow-up. BMJ Case Rep. 2018;2018:bcr2017221563.
  • Zecha JA, Mendes RA, Lindeboom VB, et al. Recurrence rate of keratocystic odontogenic tumor after conservative surgical treatment without adjunctive therapies - A 35-year single institution experience - A 35-year single institution experience. Oral Oncol. 2010;46:740–2.
  • Alnofaie H, Alomran O, Ababtain R, Alomar A. Spontaneous Eruption of a Deeply Impacted Premolar After Conservative Treatment of an Associated Dentigerous Cyst: A Case Report. Cureus. 2019;11:e6414.
  • Castro-Núñez J. An Innovative Decompression Device to Treat Odontogenic Cysts. J Craniofac Surg. 2016;27:1316.
  • Berti Sde A, Pompermayer AB, Couto Souza PH, Tanaka OM, Westphalen VP, Westphalen FH. Spontaneous eruption of a canine after marsupialization of an infected dentigerous cyst. Am J Orthod Dentofacial Orthop. 2010;137:690-3.
  • Harokopakis-Hajishengallis E. Physiologic root resorption in primary teeth: molecular and histological events. J Oral Sci. 2007;49:1-12.
  • Boot AM, de Ridder MA, Pols HA, Krenning EP, de Muinck Keizer-Schrama SM. Bone Mineral Density in Children and Adolescents: Relation to Puberty, Calcium Intake, and Physical Activity. J Clin Endocrinol Metab 1997;82:57–62.
  • Gandhi S, Franklin DL. Presentation of a radicular cyst associated with a primary molar. Eur Arch Paediatr Dent 2008;9:56–9.
  • Moturi K, Puvvada D, Kotha PR. A Novel, Minimally Invasive Technique in the Management of a Large Cyst Involving the Maxilla in a Child: A Case Report. Cureus. 2018;10:e2503.
  • Nawaz MS, Yazdanie N, Faheemuddin M. Rehabilitation of a cystic mixed dentition mandible following marsupialization with a multipurpose acrylic splint acting as a space maintainer and an obturator. J Ayub Med Coll Abbottabad. 2011;23:177-9.
  • Kolokythas A, Fernandes RP, Pazoki A, et al. Odontogenic keratocyst: to decompress or not to decompress? A comparative study of decompression and enucleation versus resection/peripheral ostectomy. J Oral Maxillofac Surg 2007;65:640–4.
  • Uloopi KS, Shivaji RU, Vinay C, Pavitra, Shrutha SP, Chandrasekhar R. Conservative management of large radicular cysts associated with non-vital primary teeth: a case series and literature review. J Indian Soc Pedod Prev Dent. 2015;33:53-6.
  • Koca H, Esin A, Aycan K. Outcome of dentigerous cysts treated with marsupialization. J Clin Pediatr Dent. 2009;34:165-8.
  • Jones AV, Franklin CD. An analysis of oral and maxillofacial pathology found in children over a 30-year period. Int J Paediatr Dent. 2006;16:19-30.
  • Narang RS, Manchanda AS, Arora P, Randhawa K. Dentigerous cyst of inflammatory origin-a diagnostic dilemma. Ann Diagn Pathol. 2012;16:119-23.
  • Gültelkin SE, Tokman B, Türkseven MR. A review of paediatric oral biopsies in Turkey. Int Dent J. 2003;53:26-32.
  • Ramakrishna Y, Verma D. Radicular cyst associated with a deciduous molar: A case report with unusual clinical presentation. J Indian Soc Pedod Prev Dent. 2006;24:158-60.
  • Shibata Y, Asaumi J, Yanagi Y, et al. Radiographic examination of dentigerous cysts in the transitional dentition. Dentomaxillofac Radiol. 2004;33:17-20.
  • Ozturk G, Dogan S, Gumus H, Soylu E, Sezer AB, Yilmaz S. Consequences of Decompression Treatment With a Special-Made Appliance of Nonsyndromic Odontogenic Cysts in Children. J Oral Maxillofac Surg. 2022;80(7):1223-37.
Toplam 29 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm ORJİNAL MAKALE
Yazarlar

Enes Özkan 0000-0002-8182-9042

Bilal Özmen 0000-0002-4435-288X

Yayımlanma Tarihi 20 Ocak 2023
Kabul Tarihi 20 Aralık 2022
Yayımlandığı Sayı Yıl 2023 Cilt: 28 Sayı: 1

Kaynak Göster

Vancouver Özkan E, Özmen B. The treatment of different odontogenic cysts in children only using acrylic appliance-guided decompression: A long-term clinical study. Anadolu Klin. 2023;28(1):15-23.

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