Odontojenik Kistlerin Cerrahi Tedavi Protokollerinin Değerlendirilmesi

Öz

Bu çalışmanın amacı odontojenik kaynaklı kistlerin tedavisinde kullanılan cerrahi yöntemleri değerlendirmek ve kemik iyileşmesini klinik ve radyolojik olarak değerlendirmektir. Çalışmaya Ağız, Diş ve Çene Cerrahisi kliniğinde 1 Ocak 2015-1 Ocak 2019 tarihleri arasında cerrahi tedavileri gerçekleştirilen ve histopatolojik olarak odontojenik kist tanısı almış hastalar dahil edilmiştir. Hastaların yaşı, cinsiyeti ve sistemik hastalıkları hem numerik hem de yüzde olarak değerlendirilmiştir. Kistik lezyonun vertikal olarak en geniş olduğu süperior-inferior (Sİ) ve horizontal olarak en yaygın olduğu mezio-distal (MD) mesafeler Romexis Viewer 3.4.1 programındaki ilgili dijital araç ile işaretlenerek pre-operatif olarak ve post-operatif 6. ayda alınmış panoramik radyografiler üzerinde ölçülüp kaydedilmiştir. Ayrıca pre-operatif ve post-operatif ölçümler arası farklar fark Sİ ve fark MD olarak kaydedilmiştir. Dahil edilme kriterleri göz önüne alındığında cerrahi olarak enükleasyon ve/veya marsupyalizasyon yapılan, histopatolojik olarak kist tanısı konmuş 38 hasta belirlenmiştir. Hastaların 23’ü (%39.5) erkek, 15’i (%60.5) kadındır. Histopatolojik değerlendirme sonucu bu hastaların 23’ünde (%60.5) radiküler, 9’unda (%23.7) dentigeröz, 6’sında (%15.8) keratokist olduğu tespit edilmiştir. Uygulanan tedavi şekline göre bu hastaların 17’sine (%44.7) marsüpalizasyon, 21’ine (%55.3) enükleasyon uygulanmıştır. Post-operatif 6. ayda kemik rejenerasyonunun marsüpyalizasyonla tedavide enükleasyona kıyasla istatistiksel olarak anlamlı olmasa da daha iyi sonuçlar gösterdiği görülmüştür(p>0,05). Fark Sİ değerinin mandibulada anlamlı olarak arrtığı gözlenmektedir (p<0.05). Fark MD ve Fark Sİ değerleri için diğer bütün parametreler açısından anlamlı fark bulunmamıştır (p>0.05). Odontojenik kistlerde en çok kullanılan tedavi yöntemleri enükleasyon ve marsüpyalizasyondur. Post-operatif 6. ayda her iki tedavi modalitesinin de kemik iyileşmesi açısından birbirine üstünlüğü bulunmamaktadır

Anahtar Kelimeler

• Cerrahi dekompresyon
• Odontojenik kist
• Enükleasyon

EVALUATION OF THE SURGICAL TREATMENT PROTOCOLS OF ODONTOGENIC CYSTS

Öz

The aim of this study is to evaluate the surgical modalities used in the treatment of odontogenic cysts and examine the bone healing after surgical treatment. Patients who were treated surgically and histopathologically diagnosed as odontogenic cyst between January 1 2015 and January 1 2019 were included in the study. The vertical dimensions (SI) and horizontal dimensions (MD) of the cystic cavities were measured on the computer software program with appropriate measurement tool. The measurements were done on panoramic radiographs taken preoperatively and at postoperative 6th-month. The difference between preoperative and post-operative SI and MD measurements were also calculated. Thirty eight patients were included in the study. Fifteen of them (%60.5) were female and 23 (%39.5) of them were female. Twenty one patients (%55.3) were treated with enucleation and 17 patients (%44.7) were treated with marsupialisation. The number of patients who were histopathologically diagnosed as radicular cyst, dentigerous cyst and odontogenic keratocyst were 23 (%60.5), 9 (%23.7) and 6 (%15.8), respectively. The dimensions of cystic cavities did not show significant change at post-operative 6th-month follow-up period (p>0.05), however, increased bone regeneration was observed at marsupialization group. Difference SI was significantly higher in odontogenic cysts that were diagnosed on mandible (p<0.05), whereas all other parameters did not show statistically significant changes for difference MD and difference SI measurements. Enucleation and marsupialization are the most common surgical modalities used in the treatment of odontogenic cysts. Both treatment methods show similar levels of bone regeneration at the end of 6th-month follow-up.

Anahtar Kelimeler

• Surgical decompression
• Odontogenic Cyst
• Enucleation

Kaynakça

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