Dekompresija kao metoda liječenja radikularne ciste

master's thesis

• Title (english): Decompression as method of radicular cyst treatment
• Author: Ana Bakula
• Mentor: Zoran Karlović (mentor)
• Committee member: Zoran Karlović (predsjednik povjerenstva)
• Committee member: Bernard Janković (član povjerenstva)
• Committee member: Vlatko Pandurić (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Department of Endodontics and Restorative Dentistry); Zagreb
• Defense date and country: 2022-09-22, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine

Abstract

Odontogene ciste patološke su lezije u kostima maksilofacijalne regije. Etiološki se dijele na razvojne i upalne. Razvojne nastaju kao poremećaj u odontogenezi, dok upalne nastaju uslijed traume ili širenjem infekcije kroz parodont ili nekrotiziranu pulpu. Ciste predstavljaju velik izazov u dijagnostici za terapeuta jer rastu asimptomatski, u smjeru manjeg otpora kosti. Svojim povećanjem mogu oslabiti kost i ugroziti vitalitet zuba. Prodorom mikroorganizama moţe se javiti oteklina i bol. U dijagnostičke svrhe pomaţu radiološke snimke na kojima je cista prikazana kao radiolucentno prosvjetljenje u bliskoj vezi sa zubom. Cone beam kompjutorizirana tomografija (CBCT) daje trodimenzionalni prikaz koji pruţa dodatne informacije o veličini ciste i odnosu prema okolnim strukturama. Ciste manjeg promjera liječe se enukleacijom - ljuštenjem cistične šupljine i poticanjem na stvaranje krvnog ugruška te zatim šivanjem tako da tkivo cijeli per primam intentionem. Takav pristup nije pogodan za ciste većeg promjera jer bi se enukleacijom uništili okolni zubi i anatomske strukture. Metoda dekompresije pokazala se boljim, konzervativnijim i
poštednim pristupom liječenju cista. Pomoću cjevčice drenira se cistični sadrţaj te se tako smanjuje intraluminalni tlak. Kontrolne radiološke slike pokazuju smanjenje volumena ciste i stvaranje nove kosti, osobito u liječenju radikularnih cisti, ali i mnogo agresivnijih tvorbi kao što je ameloblastom ili odontogena keratocista. U slučajevima većeg promjera ciste koja svojim rastom moţe kompromitirati nosnu ili sinusnu šupljinu, donji alveolarni ţivac, vitalitet više zuba ili povećati rizik od frakture mandibule, dekompresija je inicijalna kirurška terapija.

Abstract (english)

Odontogenic cysts are pathological lesions in maxillofacial bones. Etiologically, they can be classified as developmental and inflammatory. Developmental cysts appear as an odontogenesis disorder, while inflammatory cysts appear due to trauma or by infection spreading through periodontium or necrotic pulp. Cysts present a great challenge in diagnostics for therapists because they grow asymptomatically, in a direction of low bone resistance. Their augmentation can weaken the bone and risk tooth vitality. The penetration of microorganisms can cause swelling and pain. Radiological images help with diagnosis. A cyst is presented as radiolucent halo closely connected to the tooth. Cone-beam computed tomography (CBCT) gives three-dimensional display which provides additional information on the size of the cyst and on its relationship towards surrounding structures. Smaller cysts are treated by enucleation – peeling of the cystic cavity, encouraging blood clot
creation, and then sewing so that the tissue heals per primam intentionem. That kind of approach is not suitable for larger cysts because enucleation would ruin surrounding teeth and anatomic structures. Decompression method proved to be a better, more conservative, and sparing approach to cysts treatment. Cystic content is drained by using a tube and, in that way, intraluminal pressure is reduced. Control radiological images show a decrease in cyst volume and new bone creation, particularly in radicular cyst treatment as well as in much aggressive creations such as ameloblastoma or odontogenic keratocyst. Decompression is the initial surgical therapy in cases of larger radius cysts which can grow and by growing compromise nose or sinus cavity, lower alveolar nerve, vitality of several teeth or increase the risk of mandibula fracture.

• Keywords: odontogene ciste; konična računalna tomografija; kirurška dekompresija
• Keywords (english): Odontogenic Cysts; Cone-Beam Computed Tomography; Surgical Decompression
• Language: croatian
• URN:NBN: urn:nbn:hr:127:758275
• Study programme: Title: dental medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica dentalne medicine (doktor/doktorica dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Access restricted to students and staff of home institution
• Created on: 2022-11-10 08:20:59