Oral Surgery Flashcards
(44 cards)
What is the definition of a cyst?
a pathological cavity with fluid or semi-fluid contents, which has not been created by the accumulation of pus
Name 12 signs and symptoms of cysts
- asymptomatic
- boney expansion
- fluctuant swelling
- missing teeth
- carious, discoloured, fractured teeth
- tilted/displaced teeth
- discharge/sinus
- loose teeth
- mental hypoaethesia
- hollow percussion note
- pain and swelling if secondarily infected
- pathological fracture
what investigations can be used for cysts?
- vitality test
- radiology
- aspiration of cyst contents
- biopsy
what are the management aims for cyts?
eradicate pathology
minimise surgical damage
restore function quickly
what are the treatment options for cysts?
marsupialisation
enucleation
marsupialisation & enucleation
enucleation and curettage/excision
en bloc resection-jaw continuity maintained
partial resection-continuity lost
how do you decide between enucleation and marsupialisation?
depends upon:
type
size
site
medical status
what can be done alongside enucleation if teeth are to be preserved?
peri-radicular surgery
what is enucleation?
complete removal of the cyst lining
when would enucleation be contraindicated?
large cysts
involving a number of vital teeth
in difficult anatomical site
involving potentially useful unerupted tooth
why is elimination of dead space important?
reduce reactionary haemorrhage
reduce post-op infection
how can dead space be eliminated?
drain placement - sucks out stuff
saucerisation? - collapse walls of cavity
pack with pts own bone (autograft) or allograft or xenograft
layered soft tissue close (suture muscle etc into area)
secondary intention (packing with sedative dressing but needs visits to change it - uncomfortable)
what are the advantages of enucleation?
complete removal for histology
cavity heals without complications
what are the disadvantages of enucleation?
infection
incomplete removal of lining
damages to adjacent teeth or antrum
weakening of bone
what is marsupialisation?
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 by subsequently removed
when would you choose marsupialisation over enucleation?
large cyst involving healthy useful teeth
older frail ppl
when tooth can erupt through - incisors and canines
what kind of healing in marsupialisation?
secondary - granularion tissue `
what are the advantages of marsupialisaton?
avoids pathological fracture
tx for medically compromised pts -avoids GA
avoids damage to adjacent structures
allows potentially useful teeth to erupt
what are the disadvantages of marsupialisation?
orifice closes and cyst reforms
repeat visits
manual dexterity and compliance
complete lining not available for hisotology
what is a radicular cyst
inflammatory in origin associated with a non-vital tooth
what % of dental cysts are radicular
60
what are the 2 collateral cysts
paradental
mandibular buccal bifurcation cyst
what is the incidence of dentigerous cyst
10-15%
what is the incidence of keratocyst
5-10%
what is the incidence of paradental cyst
3-5%
