School of Dental Medicine, University of Zagreb, Croatian Dental Society - Croatian Medical Association
Abstract
U radu je postavljeno pitanje vrijednosti marsupijalizacije kao metode liječenja čeljusnih cista i cističnih odontogenih tumora. Postupak je obavljen retrospektivnom raščlambom uzoraka od 71 pacijenta obrađenog u dvanestogodišnjemu razoblju u Kliničkom zavodu za oralnu kirurgiju i u Klinici za kirurgiju čeljusti i lica Kliničke bolnice Dubrava u Zagrebu. Među uzorcima je bila 61 odontogena cista (85,92 %) – od kojih 14 (19,72 %) odontogenih keratocista i sedam (9,86 %) njihovih recidiva. Radikularnih i folikularnih odontogenih cista bilo je ukupno 39 (54,93 %), zatim slijedi šest traumatskih koštanih šupljina -”cista” (8,45 %), jedan odontogeni tumor (1,41 %), jedan gigantocelularni centralni granulom (1,41 %), jedan recidiv gigantocelularnog granuloma (1,41 %) i jedan centralni kavernozni hemangiom (1,41 %). Tvorbe su bile liječene svim poznatim kirurškim postupcima, a marsupijalizaciji je bilo podvrgnuto deset pacijenata - tri (9,68 %) s cistama promjera od 3 do 6 centimetara te šest ( 22,22 %) s cistama većima od šest centimetara.
Riječ je bila o odontogenim keratocistama ili njihovim recidivima te o po jednom slučaju radikularne i folikularne ciste čeljusti. Rezultati su pokazali da se marsupijalizacijom vidljivo smanjuje koštana šupljina u svim tako liječenim slučajevima te da ju je moguće primijeniti kao konačan kirurški postupak kojim se mogu potpuno izliječiti odontogene keratociste ili druge odontogene ciste čeljusti. No, kako su rezultati preliminarni, postupak ipak treba primjenjivati racionalno.The investigation raises the question of the value of marsupialization as a method for treatment of jaw cysts and cystic odontogenic tumours. The study comprises a retrospective analysis of a sample
of 71 patients treated during a twelve-year period in the Clinical Department of Oral Surgery and the Clinic of Maxillofacial Surgery of the University Hospital Dubrava. The sample consisted of 61 odontogenic cysts (85.92%), among which 14 (19.72%) were odontogenic keratocysts and 7 (9.86%) recurrences of odontogenic keratocysts. There were 39 (54.93%) radicular and follicular odontogenic cysts, 6 traumatic bone cavities “cysts” (8.45%), one odontogenic tumour (1.4%), one giant-cell central granuloma (1.41%), one recurrence of a giant-cell granuloma (1.41%) and
one central cavernous hemangioma (1.41%). The formations were treated by all known surgical procedures, and marsupialization was undertaken in 9 patients of which 3 (9.68%) with cysts 3-6 cm in diameter and 6 (22.22%) with cysts larger than 6 cm. They were odontogenic keratocysts or their recurrences and one case each of a radicular and follicular jaw cyst. The results showed that marsupialization visibly reduced the bone cavity in all cases treated by this method and indicated that it could be applied as the final surgical procedure in which a complete cure is possible of odontogenic keratocysts or other odontogenic cysts of the jaws. However as the results are preliminary the procedure should be applied rationally
