Oral surgery - management of cysts Flashcards
why is there fluid in the centre of a cyst
cells undergone apoptosis
what is the process that drives the process of a cyst
hydrostatic fluid
what presents once the cyst has removed the overlying bone
expansion of the mucosa
soft touch
fluctunate swelling
wehn do cysts become symptomatic
when they are so large that they brach the bone and mucosa and opening is created such as a sinus which allows for infection to transmit
this when symptoms begin to show
bony expansion will lead to what
egg shell cracking
tingling sensation
paraesthseia
tooth associated with cyst - hollow percussion note
if you palpate and it is hard what does that mean
it means it is a slow growing cysts as the bone has been able to repair the bone to ward of the hydrostatic pressure
fluctuant swelling means what for the bone
bone has been eroded
MTA used as a root seal
periradicular surgery to treat periradicular cysts
investigation include
vitality test
radiology - pa
aspiration
biopsy
if the content of the biopsy cyst is clear and small crystals
= inflammatory radicular cyst
if the content of the biopsy cyst is thick and viscous
= other cysts not inflammatory radicular cyst
cyst like radioluciencies - means it appears as a cyst but unless you have confirmed it to be cyst you cannot call it
management of cyst
first line management
enucleation
what determines enculeation of cyst
size
location
GA
what is enucleation
complete removal of cyst
area heals with blood > granulation tissue > bone formation
enucleation contraindication
This maybe contraindicated if the cyst is large, involving a number of vital teeth, in a difficult anatomical site or involving a potentially useful unerupted tooth.
auto graft - from yourself
allograft - from another human
xenograph - from an animal
advanatges of enclueation
Complete removal for histology
Cavity heals without complications
disadvantages of enucleation
Infection
Incomplete removal of lining
Damages to adjacent
teeth or antrum
Weakening of bone
what is marupialisation
This involves the creation of a window in the cyst lining, suturing the flap to the remaining lining to allow shrinkage of the lesion which may become self cleansing or be subsequently removed.
treatment with dentigerous cyst
enucleation with removal of associated tooth [wisdom teeth]
marsupialisation if unerupted tooth is potentially fuctional and can be aligned orthodontically [maxillary canines]
what is en bloc resection
cut out of bone with cyst plus margin of bone that is clear
