School of Dental Medicine, University of Zagreb, Croatian Dental Society - Croatian Medical Association
Abstract
Prikazana su dva slučaja odontogenih keratocista od kojih se jedna pojavila na suprotnoj strani čeljusti nakon operacije folikularne ciste druge strane čeljusti, a druga je recidivirala u razmjerno kratku vremenu. Ni u jednome slučaju nije dokazana mogućnost postojanja Gorlin-Goltzova sindroma. Obje su odontogene keratociste kirurški liječene enukleacijom cistične čahure i poslijeoperacijskom intraoralnom sukcijom s time da je u drugome slučaju isti postupak ponovljen i prigodom pojave recidiva.
Činjenica da trajna intraoralna poslijeoperacijska sukcija osigurava cijeljenje koštanoga tkiva donje čeljusti u razmjerno kratku vremenu, pri liječenju odontogene keratociste nije utjecala na mogućnost razvoja recidiva. Autori zato zaključuju da pri liječenju odontogenih keratocista nije važno koji ćemo kirurški postupak provesti, ako se služimo konzervativnim kirurškim postupkom. Metodu masupijalizacije u tim slučajevima treba potpuno napustiti. Druge konzervativne kirurške metode nose rizik recidiva i ako se recidivi više puta ponavljaju moguće je da keratocista prodre u meka tkiva gdje ju je teže kirurški pratiti. Autori smatraju da je raščlambom odgovarajućeg kliničkog uzorka potrebno procijeniti koliko se često javljaju ozbiljni recidivi odontogenih keratocista sa širenjem u meka tkiva ili druge perioralne strukture. O tim podatcima ovisi treba li pri liječenju recidiva odontogenih keratocista zauzeti stajališta kakva postoje pri liječenju svih lokalno invazivnih odontogenih tvorbi.Two cases of odontogenic keratocysts are presented of which the first occurred on the opposite side of the jaw after an operation for a follicular cyst, and the other recurred within a relatively short period. In neither case was the existence of Gorlin-Goltzov syndrome possible. Both odontogenic keratocysts were surgically treated by enucleation of the cystic capsule and postoperative intraoral suction. In the second case the procedure was repeated due to a recurrence. The fact that permanent intraoral postoperative suction ensures the healing of mandibular bone tissue in a relatively short time, it had no influence on the possibility of the development of a recurrence during the treatment of an odontogenic keratocyst. The authors therefore conclude that during the treatment of odontogenic keratocysts the surgical method used is not important if the surgical method used is conservative. In such cases the marsupialisation method should be completely abandoned. Other conservative surgical methods include the risk of recurrence, and should the recurrence occur repeatedly there is a possibility of the keratocyst penetrating into the soft tissue where it is more difficult to treat surgically. The authors consider that by analysing the relevant clinical sample it is necessary to calculate how often severe recurrences of odontogenic keratocysts occur with expansion into the soft tissue or other perioral structures. Thus these data could be used during the treatment of recurrences of odontogenic keratocysts, in view of the perspectives which exist in the treatment of all locally invasive odontogenic formations
