Odontogenic cyst
Odontogenic cysts (from Greek: ὀδούς Odous " the tooth" and γὲνεσις genesis " origin " ) ( originating from dental cysts ) are cysts in the jaw region, their origin or genesis goes back to teeth or dental education institutions. They are surrounded by a separate wall, which consists of connective tissue and is lined with epithelium. They contain a liquid or pasty content. They grow purely expansive ( displacing ) are benign lesions and usually painless, as long as they are not infected. They grow slowly, the mucous membrane of the cyst remains displaced. For larger cysts can cause swellings in the oral vestibule or even outside in the mandibular angle region. Under pressure you can possibly perceive a parchment -like crackling, namely, when breaks the often extremely thin outer bone lamella. Because of their analgesia Odontogenic cysts are often " minor findings " at X-ray control recordings.
- 2.1 cystectomy
- 2.2 cystostomy
- 2.3 Antrozystektomie
Classification of odontogenic cysts
Odontogenic cysts are divided into:
Radicular cysts
A radicular cyst is formed in the vicinity of the root tip of a non-vital ( non-vital ) tooth in the result of chronic inflammation at the root tip ( chronic apical periodontitis ). The cyst lumen ( cavity ) is filled with a yellowish penetrated by cholesterol crystals liquid. A radicular cyst may remain even after the removal of the tooth and continue to grow when the fibrous cyst capsule ( cyst ) is not carefully removed. (See below: Residual cysts ). Infected cyst contents with pyogenic organisms, it may lead to an abscess. On deciduous teeth radicular cysts occur only very rarely.
Follicular cysts
A follicular cyst is formed by an expansion of the dental follicle in the crown area of an impacted ( hindered the breakthrough ) tooth, very often at lower wisdom teeth, upper canine teeth and supernumerary teeth. As with the radicular cyst follicular cyst is filled with a yellow fluid penetrated by cholesterol crystals.
Primordial cysts
A primordial cyst is the cause in any way connected to the dental system, but goes by the epithelium of the tooth bud before they mineralized. Primordial cysts occur rarely.
Periodontal cysts
A Periodontal cyst is in no way associated with non-vital teeth or tooth follicles. It has its origin in perikoronalen (around the crown around ) Bag inflammation and thus developed adjacent to the tooth, usually at about the level of the dental neck.
Gingival cysts
Gingival cyst is rare and occurs as a bluish transparent solid nodules preferably in the region of the lower canines and premolars. Cause: Probably remains of the enamel- forming epithelium. This respect are Gingival cysts near the Primordial cysts, but are localized differently.
Dentitionszysten
A Dentitionszyste (also: eruption cyst ) forms (mostly in deciduous teeth ) over a unerupted tooth. Because of the growing tooth eruption cyst usually breaks itself is an ablation of the gingiva usually not necessary. Treatment: removal of the gingiva only in inflammation, infection, pain.
Residual cysts
A residual cyst is a cyst that (see above) has remained afflicted tooth after extraction of a radicular cyst with and continues to grow.
Therapy
The aim of treatment is to remove the pressure from the cavity (to prevent further growth ) and to remove the cyst, together with connective tissue and epithelium or the cyst cavity, at least so far reveal that the cystic epithelium can convert oral mucosa. Depending on the location of the cyst, it may be (eg, oral or maxillary sinus ) is assigned as " bay side " of another cave.
Cystectomy
When cystectomy (also called " operation Partsch II" ), the cyst following a mucosal incision is opened ( arch incision Partsch ), fenestrated bone and cyst including cystic epithelium from the bone " peeled out ". In order to achieve a primary wound healing, the wound is sutured, such that the cavity can be full bleed. In the context of wound healing and raised in the resulting coagulum one capillaries and it organizes itself to granulation tissue. After the removal of large cysts, including larger bone defects, this primary wound healing may be impaired. Since a large coagulum more contracted ( with the same percentage contraction - greater absolute contraction ), it has no more contact with the bone walls and no capillaries grow. Instead decomposes the coagulum - purulent ( putrid ) / necrotic. To avoid the risk of this complication can be tried at large cysts to stabilize the clot and reduce its contraction ( autologous blood before surgery, mixing this blood with antibiotics, or filling of the bone defect with granules of bone substitutes ). If it is a radicular cyst, one connects the cystectomy usually with an apical resection, while still a root canal treatment can be performed during surgery, if that was not done previously.
Cystostomy
To avoid the problems of an unstable blood clot, is the case of larger cysts alternative cystostomy (read: cysto - ostomy, and not: Cyst -Os - Tomie - from Greek στόμα ( stoma, stomatos ) " mouth ", " mouth ", " orifice "," hole " ) (also called" operation Partsch I "or" marsupialization called "). Here, the cyst is not completely removed, but to a side bay of a natural body cavity (mouth, nose or antrum ). Here, the cyst is large area opened, possibly sewn to the remaining cyst skin and initially tamponade. The wide opening of the cyst of the print is taken from the cyst, it stops growing, the cystic epithelium gradually transforms into mucosal epithelium and the cavity often forms - albeit slowly - back by regenerated bone from the bottom. A cystostomy is also recommended instead of a cystectomy, when can these important anatomical structures are damaged in the immediate vicinity of the cyst.
Antrozystektomie
See Antrozystektomie