School of Dental Medicine, University of Zagreb, Croatian Dental Society - Croatian Medical Association
Abstract
Postoje dva moguća kirurška postupka u liječenju velikih jedinstveno složenih odontoma ili drugih odontogenih tumora donje čeljusti. Jedan je klasičan kirurški postupak, kao u slučajevima alveotomija retiniranih ili inpaktiranih zuba, i moguće ga je izvesti kad je riječ o manjim primjerima odontoma u kojima je okolna kost dovoljno sačuvana i ne postoji opasnost od patološkog ili jatrogenoga prijeloma donje čeljusti. Taj je zahvat također moguć i kod većih odontogenih tumora koji se lako ljušte iz njihova koštanoga ležišta. Drugi je postupak odstraniti tumor s pomoću takozvane sagitalne osteotomije donje čeljusti, kao što su to opisali Rittersma J. i van Gool AV. godine 1979.
Autori prikazuju primjer neobično velikoga jedinstveno složenog odontoma u angulusu donje čeljusti u 23-godišnjeg muškarca. Zbog mogućega prijeloma čeljusti tijekom zahvata u jednom aktu, izvršen je dvofazni kirurški postupak koji se je pokazao uspješnim i prihvatljivim za pacijenta. Autori navode podatke iz literature, raspravljaju o prednostima i nedostatcima različitih kirurških postupaka ostavljajući slušateljstvu da ocijeni opravdanost pojedinih potupaka primjenjivanih do danas.Two methods are possible in the surgical treatment of large examples of complex odontomas or other odontogenic tumors of the mandible.
One is classical intraoral approach, as in the case of alveotomy of retained or impacted teeth, wich im simple to perform in the case of small examples of odontomas, where the bone is still sufficiently preserved, and there is consequently no danger of pathological or iatrogenic fracture of the jaw. It is also possible in the case of large tumors that are easily denucleated from the bony site.
Another method is to remove the tumor by means of so-called sagittal osteotomy of the mandible described by Ritersma J, and van Gool AV. 1979.
The authors present an example of an unusually large, complex odontoma of the mandibular angle of a 23 yearold man. Because of the possibility of fracture during the operation in one step a two phase surgical procedure was applied, wich proved successful and was acceptable for the patient. The authors cite data from the literature, discussing advantages and disadvantages of different surgical procedures, leaving the audience to decide on justification of all applied surgical procedures to date
