Şefik Sinan KÜRKÇÜOĞLU, Hasan Mete İNANÇLI, Ümit TUNCEL, Selahattin GENÇ, YETKİN AĞAÇKIRAN

Treatment of mandibular large calcifying odontogenic cyst without grafting: A case report

Çenede gelişim gösteren odontojenik kistler sıklıkla mandibula ramus’u ve korpus’unda yerleşim göstermektedir. Histopatolojik incelemelerinde bazal tabakada palizatlaşma ve geniş keratinize ‘ghost’ hücre kitle görünümü ile karekterizedirler. Odontojenik keratokist’ler klinik ve patolojik olarak hızlı büyüme ve yüksek oranda tekrar oluşum göstermeleri sebebiyle önemlidirler. Tedavide ise farklı cerrahi teknikler uygulanabilmektedir. Kliniğimize mandibula korpus’unda şişliği olan ve aralıklarla akıntısı olduğunu ifade eden 56 yaşında erkek hastanın yapılan muayenesinde 5x5 cm büyüklüğünde sert düzgün yüzeyli bir kitlesi olduğu tesbit edildi. Kitle periost ve kapsülü ile birlikte mandibula’dan diseke edilerek total olarak çıkarıldı. Patolojik incelemede ‘’kalsifiye odontojenik keratokist’’ tanısı kondu. Hastanın iki yıl boyunca takibi sırasında herhangi bir tekrar oluşuma rastlanmadı. Greftlemelemeye gerek kalmadan odontojenik kist tedavisi mümkündür. Biz bu vakada greftlemeye ya da herhangi bir implant ihtiyacı olmadan büyük bir kalsifiye odontojenik kistin eksiyonunun mümkün olduğunu göstermeye çalıştık. Bu yaklaşımla olası greft ya da mandibula protezi komplikasyonlarından hastayı korumuş olduk.

Büyük kalsifiye odontojenik kistin greftsiz tedavisi: Olgu sunumu

Odontogenic cysts in the jaw are usually located in the mandibular ramus and corpus. In histopathological examination, they are characterized with palisading in the basal layer and large keratinized ‘ghost’ cell tumor appearance. Odontogenic cysts are important due to their quick growth clinically and pathologically and their high rate of recurrence. Various surgical techniques may be used in its treatment.The 56-year-old male patient admitted to our clinic with complaints of a nodule in his mandibular corpus and intermittent leakage was found to have a 5x5 cm. hard and smooth tumor. The tumor was removed by dissection from the mandibula together with its periosteal and capsule. The pathological examination led to the diagnosis of a calcifying odontogenic cyst. No recurrence was seen during the two-year follow-up of the patient. In our case, no recurrence was seen in the clinical follow-up for two years after the operation. This means that odontogenic cyst treatment is possible without grafting. We would like to focus the interest on surgical treatment of a calsifying odontogenic cyst surgery is possible without grafting and mandibular prosthesis implantation. In this way, graft resorption or implant complications may be avoided.

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