New approach to the treatment of odontogenic cysts of jaws

Abstract

In the structure of benign neoplasms of the maxillofacial region, the number of odontogenic cysts reaches 55 %. The main task in the treatment of cysts is the preservation of the functional usefulness of the tooth, which is often not performed due to objective reasons. The search remains to find the most effective means and methods for treating the bone cavity and the root of the tooth after endodontic treatment at the stage of cystectomy with the condition of maintaining the physiological length of the tooth root.

Goal. Increase the effectiveness of treatment of odontogenic cysts of the jaws when using a combination of ultrasound and medicamental effects.

Materials and methods. Twenty-five patients with a diagnosis of radicular cyst (cysts) were examined and operated at the age of 26 to 53 years: 2 groups – primary (OG) – 15 persons, control (CG) – 10 people. In the KG group, the operation was performed according to the traditional method, with the appointment of complex antibiotic therapy.

OG patients underwent a cystectomy according to the proposed method with the use of a drug whose active ingredient is a 36 % solution of polycresulenic acid, sonication of the cyst cavity and the apex of the root, filling the cyst cavity with a dental sponge. In the postoperative period, resorption was prescribed, the active ingredient of which is decamethoxin.

Results. OG patients already had an active lifestyle for 3-4 days after surgery. In the CG, only on the 7th day patients could lead an ordinary life. Follow-up examination at 3 months: in KG – the bone tissue of the spongy structure was determined, with areas of heterogeneity, in the OG – a portion of bone tissue with a less distinct pattern was determined in comparison with the surrounding tissue. The proposed method allowed to preserve the length of the root of the tooth, actively influence the osteoreparation with minimization of the allergic action of the drugs, reduce the number of complications in the postoperative period and accelerate the regeneration of bone tissue after surgical intervention.

Conclusions. The proposed method of cystectomy allows to increase the effectiveness of treatment of odontogenic cysts and cysts, preserve the functional usefulness of the tooth, accelerate the wound healing process by providing complete osseointegration, which is a promising aspect in the subsequent orthopedic treatment and preservation of the physiological status of the dentoalveolar system.

Keywords: оdontogenic cysts, cystectomy, bacteriostatics, ultrasound.