Radicular cysts of a jaw
- Symptoms of Radicular cysts of a jaw
- Reasons of Radicular cysts of a jaw
- Treatment of Radicular cysts of a jaw
Okoloverkhushechny cysts of a jaw are tumoral educations which initial push of growth is inflammatory process in a tooth periodontium therefore they should be considered as further development of chronic inflammatory process with participation of the remains of the embryonal epithelium forming further an epithelial vystilka of a cover of a cyst.
Symptoms of Radicular cysts of a jaw:
In the absence of subjective feelings detection of a cyst becomes possible only at emergence of protrusion of a compact plate of a jaw or an empyema of cyst. In some cases the cyst comes to light at the X-ray inspection of a jaw conducted with other purpose.
At the same time the slow, but constant growth of a cyst without subjective feelings and without clinical symptoms can lead to big destruction of a jaw.
On an upper jaw in such cases germination of a cyst in a Highmore's bosom, in a nasal cavity is observed. On a mandible spread of a cyst on all thickness of a bone can cause a spontaneous change it.
Penetration into a cyst of virulent microbes causes suppuration with possible distribution of pus to a surrounding bone tissue and development of osteomyelitis. It .obrazy, chronic granulematozny periodontitis can be the reason of development of a radicular cyst which, destroying a jaw bone, is inclined to cause heavy complications of a local and general order.
In the absence of clinical implication (protrusion of a bone, thinning of a cortical plate of a jaw) recognition of cysts is possible only in the analysis of the roentgenogram of a jaw. Radiological the radicular cyst is defined in the form of accurately limited osteoporosis of a rounded or oval shape. As a rule, in a cavity of a cyst there is a top of a root of causal tooth. However cases are observed; when after an odontectomy concerning chronic periodontitis the granuloma was not removed, and development of a cyst followed. At the same time connection of a cyst with a root of this or that tooth radiological can be not established.
At detection of noticeable protrusion of a jaw the pergament crunch due to thinning of a compact plate of a bone often is defined by a palpation. In such cases, in addition to X-ray inspection, it is necessary to carry out a puncture for an exception of tumoral process. Transparent, a little opalescent liquid testifies to the cystous nature of a new growth. At an empyema of cyst in punctate there can be a pus. It is possible to treat small cysts conservatively, sealing of the channel. Under the influence of sealing material activity of osteoblasts amplifies and the cavity of a cyst is replaced with a bone tissue.
Reasons of Radicular cysts of a jaw:
At a granulematozny form of periodontitis the formed granuloma as a result of proliferation of granulyatsionny fabric gains sometimes rather bystry growth rate.
At a certain stage of development of a granuloma in its center there is a fusion of granulations because of lag of formation of vessels and disturbance in this regard of a trophicity.
The cavity filled with liquid is as a result formed. Growth of a radicular cyst extremely slow in this connection its clinical implication happens a little noticeable. Usually sick many years do not find any signs of growth of a cyst.
Treatment of Radicular cysts of a jaw:
Treatment of radicular cysts of the considerable sizes only surgical.
Depending on specific conditions make or partial excision of a cover of a cyst — vesicotomy, or full removal of all cover of a cyst — a cystectomy. Before carrying out these operational methods of treatment in each individual case the issue of preservation of the tooth which was the reason of development of a cyst, and also the next teeth which roots can be in direct contact with a cyst cover is resolved.
For this purpose radiological specify cyst topography, its relation to the next teeth. When causal tooth is steady and it is reasonable to keep it, carry out its treatment with antiseptic processing of the channel (or channels in case of multi-rooted tooth) and sealing of cementomas.
The teeth which are in close proximity to a cyst which roots on the roentgenogram are projected on cyst contours are exposed to similar intervention.
Need of trepanation of such teeth has a talk with the fact that, first, pressure put by a cyst upon a neurovascular bunch of tooth could cause a necrosis of a pulp or its regeneration; secondly, the possibility of damage of neurovascular bunches of the teeth, next to a cyst, when performing surgery is not excluded that, naturally, will cause a necrosis of a pulp of these teeth.
Usually final stage of preparation of teeth for operation — their sealing — is made just before operation or on the eve of it.