This document discusses cysts of the oral and maxillofacial region. It defines true cysts as pathological cavities lined by epithelium and containing fluid or gas, while pseudocysts are not lined by epithelium. Cysts are classified as either odontogenic or non-odontogenic in origin. Common types described include dentigerous, radicular, nasopalatine duct, and dermoid cysts. Diagnosis involves history, clinical examination, radiography, aspiration biopsy, and histopathological examination of surgically removed tissue. Treatment options for cysts include enucleation, marsupialization, a combination of the two, or enucleation with curettage of
Odontogenic keratocyst (OKC) is the cyst arising from the cell rests of dental lamina. It can occur anywhere in the jaw, but commonly seen in the posterior part of the mandible. Radiographically, most OKCs are unilocular when presented at the periapex and can be mistaken for radicular or lateral periodontal cyst.
Odontogenic keratocyst (OKC) is the cyst arising from the cell rests of dental lamina. It can occur anywhere in the jaw, but commonly seen in the posterior part of the mandible. Radiographically, most OKCs are unilocular when presented at the periapex and can be mistaken for radicular or lateral periodontal cyst.
A short slideshow covering the basics of Intrusive luxation and total avulsion, from an endodontic point of view.. Highlight are the photographs chosen with care to explain the points well. Ideal for under-graduate and Post-graduate students. Based on Grossman's Endodontic Practice, 13th Edition.
Tooth resorption is the progressive loss of dentine and cementum by the action of osteoclasts. This is a physiological process in the exfoliation of the primary dentition, caused by osteoclast differentiation due to pressure exerted by the erupting permanent tooth
A short slideshow covering the basics of Intrusive luxation and total avulsion, from an endodontic point of view.. Highlight are the photographs chosen with care to explain the points well. Ideal for under-graduate and Post-graduate students. Based on Grossman's Endodontic Practice, 13th Edition.
Tooth resorption is the progressive loss of dentine and cementum by the action of osteoclasts. This is a physiological process in the exfoliation of the primary dentition, caused by osteoclast differentiation due to pressure exerted by the erupting permanent tooth
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
1. Cysts Of The Oral And
Maxillofacial Region
Dr. Saleh Bakry
Assistant Professor of Oral and
Maxillofacial Surgery
2. • A Cyst is a pathological cavity having fluid,
semifluid or gaseous contents and which is
not created by the accumulation of pus and
lined by epithelium
DEFINATION OF TRUE
CYST
3. Pathological cavity not lined by epithelium and
may contain fluid or may be empty.
DEFINATION OF
PSEUDOCYST
4. Cyst has following parts:
• WALL (made of
connective tissue)
• EPITHELIAL LINING
• LUMEN OF CYST
PARTS OF A CYST
5. ODONTOGENIC:
1. Cells of the basal layer of
the oral epithelium.
2. The dental lamina.
3. The epithelial rests of
Serres (which represent
remnants of the dental
lamina).
4. The enamel organ.
5. The reduced enamel
epithelium.
6. The epithelial rests of
Malassez.
NON-ODONTOGENIC:
1. Entrapped epithelium
between embryonic
processes (fissural cysts).
2. Epithelium from remnants
of the cervical sinus (i.e.
epithelium of brnchial
cleft origin).
3. Secretory glandular
epithelium.
4. Remnants of the
epithelium of the naso-
palatine duct.
ORIGIN
7. I. ODONTOGENIC CYSTS
A. Inflammatory Apical, lateral, Residual.
B. Developmental:
1. Follicular:
• Dentigerous cyst.
• Primordial cyst.
I. CYSTS OF THE JAWS
8. 2. Extra-Follicular:
• Lateral developmental periodontal cyst.
• Gingival cysts:
Gingival cyst of the newborn.
Gingival cyst of the adult.
• Keratinizing and Calcifying Odontogenic Cyst
(Gorlin Cyst, Cystic keratinizing tumor).
9. II. NON-ODONTOGENIC CYST
A. Fissural cysts
• Nasoalveolar (nasolabial cyst).
• Median maxillary cysts.
Median alveolar cyst.
Median palatine cyst.
• Median mandibular cyst.
11. III. Pseudocysts
• Traumatic bone cyst (haemorrhagic bone cyst; solitary
bone cyst).
• Aneurysmal bone cyst.
• Static bone cyst (developmental salivary gland
inclusion cyst; latent bone cyst; Stafne's idiopathic
bone cavity).
IV. Cysts of Salivary Glands
• Mucocele.
• Ranula.
14. 1. Painless swelling.
2. Absence of a tooth or teeth.
3. Loosening or irregularity of teeth.
4. Tilting of teeth
5. Discolored tooth
I. HISTORY
15. 1. TEETH POSITION:
• Absence of tooth unerupted
dentigerous cyst.
• Not formed primordial cyst.
• Extracted residual cyst.
• Cysts displace tooth, while neoplasm
cause root resorption.
II. CLINICAL EXAMINATION
16. 2. TEETH VITALITY:
• Presence of discolored pulpless tooth
inflammatory cyst.
• Vital tooth fissural, developmental,
primordial cyst or psuedocyst.
3. SITE:
• Globulomax. Cyst between upper lateral
and canine roots.
• Naso-palatine cyst behind upper central
incisors (related to incisive canal).
17. • Cyst of palatine papilla related to palatine papilla.
• Naso-labial cyst between ala of the nose and lip.
• Primordial lower third molar area.
• OKC molar-ramus region.
• Dentigerous upper/lower third molar – upper
canine.
• Dermoid & epidermpid cysts below the tongue in
midline.
18. 4. BONE EXPANSION:
• Small cyst no bone expansion.
• Large cyst buccal plate expansion,
indentation upon pressure (ping-pong ball),
egg shell cracking, and then fluctuation.
19. • Un-infected cyst well defined radiolucent area
surrounded by sharp radioopaque margin.
• 2ry infected radiolucency with an irregular
margin.
• Special appearance:
Nasopalatine cyst heart shaped
appearance (due to superimposition of
anterior nasal spine on its R.L. area).
Globulomaxillary cyst inverted pear
shaped (as it diverts roots of 2 and 3).
III. RADIOGRAPHIC EVALUATION
20. Traumatic bone cyst scalloped appearance
(roots determine shape of cyst).
Aneurysmal bone cyst soap bubble
appearance (pumping action of the blood).
Primordial cyst multilocular R.L.
22. This technique is used to visualize soft tissue cysts and sinus
tracts and to differentiate a maxillary cyst from the maxillary
sinus.
This technique is contraindicated in patients with severe renal
disease and hepatic disorders.
IV. OTHER RADIOLOGICAL DIAGNOSTIC
TECHNIQUES (INJECTION OF RADIOPAQUE
CONTRAST MEDIA)
23. Def.: it is the removal of tissue from a living individual
for microscopic diagnostic examination. It is the most
definitive confirmatory process for diagnosis.
Value of biopsy:
Proper and correct diagnosis.
Determine degree of malignancy.
Determine prognosis.
V. BIOPSY
24. • The most valuable investigation for cyst and fluctuant
lesions.
• Simple & cause minimal inconvenience of the patient.
• The aspiration can be submitted to Microscopic
examination, chemical analysis or microbiological
examination.
THE RESULT OF ASPIRATION:
• –ve solid mass or latent bone cyst.
• Air maxillary sinus / nose / traumatic bone cyst.
• Pus (foul odor) abscess / infected cyst.
• Yellowish white fluid with no foul odor keratocyst.
VI. ASPIRATION BIOPSY
25. • Straw color fluid with cholesterol crystals cystic
fuid.
• Blood (differentiated by sedimentation if left
upright for a while) vascular lesion / aneurismal
bone cyst.
• Sticky clear viscous fluid (saliva) mucocele /
ranula.
26. 1. Increasing in size leading to bone destruction.
2. Disfigurement.
3. Involvement of adjacent teeth leading to
looseness, displacement or resorption.
4. Infection.
5. Weakening of the mandible with possibility of
pathological fracture.
6. Encroaching vital structures.
7. Malignant transformation.
REASONS OF CYST
TREATMENT
27. 1. Removal of the pathological lining.
2. Conservation of erupted, partially erupted and un-
erupted teeth.
3. Preservation of adjacent vital structures
4. Restoration of the affected area to its original
form.
5. Achieve rapid healing of the surgical site.
OBJECTIVES OF CYST
TREATMENT
29. Cysts of the jaws are treated in one of the following four basic methods:
(1) Enucleation,
(2) Marsupialization,
(3) A staged combination of the two procedures, and
(4) Enucleation with curettage.
TREATMENT
30. • Enucleation is the process by which the total removal of a cystic lesion
is achieved (shelling out) without rupture of its lining if possible.
• Enucleation of cysts should be performed with care, in an attempt to
remove the cyst in one piece without frag-mentation, which reduces
the chances of recurrence by increasing the likelihood of total removal.
• However, maintenance of the cystic architecture is not always possible,
and rupture of the cystic contents may occur during manipulation.
1. ENUCLEATION
31. INDICATIONS :
• Accessible cyst.
• Small to moderate size cysts.
• Cysts which do not encroach vital structures.
• Cysts that do not involve the soft tissues.
CONTRAINDICATIONS:
• Large cyst surgical access would weaken the jaw that a fracture might
occur.
• Dentigerous cyst in a young person involving erupting teeth or tooth.
• When endangering the vitality of the teeth near the cyst.
• Cysts with friable thin membrane. E.g. keratocyst.
• Eruption cyst.
ENUCLEATION
32. ADVANTAGES:
• Removal of the entire pathological tissue.
• Healing is more rapid than marsupialization.
• Decreases the need for postoperative care and irrigation.
DISADVANTAGES:
• Possibility of damaging surrounding vital structures & teeth.
• Complete removal of the cyst lining may not be possible
when it extends to involve soft tissue.
• Risk of fracture mand or oro-antral & oro-nasal
communication.
ENUCLEATION
33. OPERATIVE PROCEDURES:
1. Enucleation through the socket.
2. Enucleation with primary closure.
3. Enucleation with space obliteration and primary
closure.
A. ENUCLEATION THROUGH THE SOCKET:
1. When extracting teeth with periapical radiolucencies
small in size.
2. Enucleation could be performed via the tooth’s socket.
ENUCLEATION
34. B. ENUCLEATION WITH PRIMARY CLOSURE:
1. L.A. or G.A.
2. Determine teeth management RCT or extraction.
3. Reflect a mucoperiosteal flap of sufficient width.
4. Gaining access to the cyst lining by bone removal & enlarge
the bony opening.
5. Evacuate the cyst collapse cyst lining facilitate cyst
removal.
6. Use bone curette, mucoperiosteal elevator to completely
remove the cyst lining from the walls of the bony cavity
while grasping it with Allis forceps.
ENUCLEATION
35. 7. Debridement and thorough observation.
8. Closure and sutures (left for 7-10 days)
9. External pressure pack for buccal approach or
palatal acrylic stent if palatal approach.
10. Routine immediate postoperative care:
• Pressure pack.
• Cold application for the 1st 24 hrs.
• Warm saline mouth bath the next 24 hrs.
ENUCLEATION
36. C. ENUCLEATION WITH SPACE OBLITERATION AND PRIMARY
CLOSURE:
1. Same steps from 1 to 7.
2. For space obliteration:
• Hemostatic resorbable sponges.
• Autogenous cancellous bone grafting.
• Allogenic bone grafting.
• DFDB.
3. Then continue steps 8 - 10.
ENUCLEATION
39. • Marsupialization, decompression, and the Partsch operation
all refer to creating a surgical window in the wall of the cyst,
evacuating the contents of the cyst, and maintaining
continuity between the cyst and the oral cavity, maxillary
sinus, or nasal cavity.
• The only portion of the cyst that is removed is the piece
removed to produce the window. The remaining cystic
lining is left in situ.
2. MARSUPIAIIZATION
40. 1. Release of the intracystic fluid.
2. Release of the intracystic pressure.
3. The functional stresses will be allowed to stimulate new
bone formation beneath the cyst membrane.
4. Causes gradual obliteration of the cyst cavity &
exteriorization of the cyst lining
5. At the end, the cystic cavity is completely replaced with
bone and the lining diminishes until it disappears.
MECHANISM
41. 1. Eruption cyst in patients below 20 years of age.
2. Dentigerous cysts to allow tooth to erupt.
3. Large cysts encroaching on the soft tissue
4. Large cysts encroaching the maxillary sinus.
5. Large cysts encroaching the nose.
6. When enucleation cause weakening of the mandible
7. When enucleation cause injury to healthy tissues.
INDICATION
42. CONTRAINDICATIONS:
1. Fissural cysts.
2. Cysts with tumor potentials as KCOC & Keratocysts.
ADVANTAGES:
1. Simple.
2. Contour of the jaw is preserved.
3. Protects neighboring structures from surgical damage.
4. Avoids possibility of developing oro-antral or oro-nasal
fistulae.
MARSUPIAIIZATION
43. Disadvantages:
1. Possible recurrence.
2. Maximum post-operative care required.
3. Sometimes difficult to clean.
4. Healing is slow especially in elderly patients.
MARSUPIAIIZATION
44. 1) Anaesthesia
2) Aspiration
3) Incision
Circular, oval or elliptic. Inverted U shaped incision with broad base
to the buccal sulcus. Mucoperioteum is reflected in this case.
4) Removal of bone
5) Removal of cystic lining specimen
6) Visual examination of residual cystic lining
7) Irrigation of cystic cavity
8) Suturing
Cystic lining sutured with the edge of oral mucosa.
In U shaped incision the mucoperiosteal flap can be turned into cystic
cavity covering the margin. The remaining is sutured to oral mucosa.
TECHNIQUE OF
MARSUPIAIIZATION
45. 9) Packing-- Prevents food contamination & covers wound margins.
Done with ribbon gauze soaked with WHITEHEAD VARNISH.
Pack removed after 2 weeks.
10) Instruct the patient to clean and irrigate the cavity regularly with oral
antiseptic rinse with a disposable syringe.
CONTINUE…
46. 11) Use of plug
Prevents contamination. Preserves patency of cyst orifice.
Plug should be stable, retentive and safe design.
Should be made of resilient material ( avoid irritation) like acrylic.
12) Healing
Cavity may or may not obliterate totally. Depression remains in the
alveolar process.
CONTINUE…
47.
48. 3. ENUCLEATION AFTER
MARSUPIALIZATION
INDICATIONS
• When bone has covered the adjacent vital structures.
• Adequate bone fill. Prevents fracture during enucleation.
• When patients find it difficult to cleanse the cavity.
• To detect any occult pathological condition.
ADVANTAGES
• Spares adjacent vital structures
• Accelerates healing process
• Development of thick cystic lining – enucleation easier
• Allows histopathological examination of residual tissue.
• Combined approach reduces morbidity
49. DISADVANTAGES
• Patient has under go second surgery and any possible
complication associated with surgery.
3. ENUCLEATION AFTER
MARSUPIALIZATION
50. 4. ENUCLEATION WITH
CURETTAGE
• Enucleation with curettage means that after enucleation a
curette or bur is used to remove 1 to 2 mm of bone around
the entire periphery of the cystic cavity
• Any remaining epithelial cells that may be present in the
periphery of the cystic wall or bony cavity must be removed.
• These cells could proliferate into a recurrence of the cyst.
51. Indications :
Remove any remaining epithelial cells that may be present to
prevent the recurrence of the cyst, as in:
• Treating an odontogenic keratocyst (parakeratotic)
aggressive clinical behavior + high rate of recurrence (20-60%)
+ daughter or satellite cysts may be found at periphery of
main cystic lesion.
• If it recurs after this treatment bone resection with 1cm
safety margin should be done.
ENUCLEATION WITH
CURETTAGE