Proprietary surgical approach to the treatment of large radicular cyst with retrograde filling of resected root canals: a clinical case report
https://doi.org/10.33925/1683-3759-2024-1018
Abstract
Relevance. Radicular cysts account for 86% of all odontogenic cysts. Recurrence rates following cystotomy and cystectomy range from 18% to 36%, and in some cases, up to 55%. The primary causes include incomplete removal of pathological tissues, damage to adjacent anatomical structures, insufficient pathogen eradication, and inadequate bone tissue regeneration.
Clinical case description. This paper presents a clinical case of a large radicular cyst affecting teeth 3.1, 4.1, 4.2, and 4.3 of the mandible. The treatment process was carried out in two stages. In the first stage, endodontic treatment was performed on the affected teeth. Seven days after the exudation subsided, the second stage involved filling the canals with a fast-setting material (FSM) Rootdent SM DMT as a sealer, followed by the placement of silver pins. Three hours after completing the endodontic treatment, a cystectomy was performed using a proprietary method that combined guided tissue regeneration, apical resection of the affected teeth, and retrograde filling of their root canals with FSM. A one-year follow-up showed full recovery, including complete bone regeneration and no gingival scarring.
Conclusion. The proposed treatment strategy for large radicular cysts has the potential to greatly minimize the need for extracting the affected teeth.
Supporting agencies: The authors declare that there was no external funding for the study. There are no individual acknowledgments to declare.
About the Authors
A. I. Musienko
Omsk State Medical University
Russian Federation
Russian Federation
Aleksandr. I. Musienko, DMD, PhD, Associate Professor, Department of the Restorative Dentistry
Omsk
K. I. Nesterova
Omsk State Medical University
Russian Federation
Russian Federation
Klimentina I. Nesterova, MD, PhD, DSc, Professor, Department of the Otorhinolaryngology
12 Lenina Str., Omsk, Russian Federation, 644099
S. G. Mikhailovsky
Omsk State Medical University
Russian Federation
Russian Federation
Sergey G. Mikhailovsky, DMD, PhD, Associate Professor, Department of the Restorative Dentistry
Omsk
I. S. Musienko
Omsk State Medical University
Russian Federation
Russian Federation
Ivan S. Musienko, student
Omsk
A. V. Lipatova
Omsk State Medical University
Russian Federation
Russian Federation
Alina V. Lipatova, student
Omsk
References
1. Tarasenko SV, Morozova EA, Tarasenko IV. Use of erbium laser for surgical treatment of root cysts of the jaws. Russian Journal of Dentistry. 2017;21(2):93-99 (In Russ.). doi: 10.18821/1728-28022017;21(2):93-99
2. Golovko AA, Tegza NV, Muzikin MI, Iordanishvili AK. Methods for treatment of extensive cysts of jaws (literature review). Russian Military Medical Academy reports. 2020;39(S3-1):25-28 (In Russ.). Available from: https://elibrary.ru/item.asp?id=44356881
3. Rios Osorio N, Caviedes-Bucheli J, Mosquera-Guevara L, Adames-Martinez JS, Gomez-Pinto D, JimenezJimenez K, et al. The paradigm of the inflammatory radicular cyst: biological aspects to be considered. Eur Endod J. 2023;8(1):20-36. doi: 10.14744/eej.2022.26918
4. Zaretskaya AS, Rabukhina NA, Semkin VA. Extensive odontogenic cysts of varying histological structure in an X-RAY film. Journal of radiology and nuclear medicine. 2010;(3):26-31 (In Russ.). Available from: https://elibrary.ru/item.asp?id=23334506
5. Avsyukov EV, Iordanishvili AK, Barinov EX, Manin AI, Skrebnev AV, Khokhlova TY. A rare complication of tooth extraction surgery. Vestnik Medicinskogo stomatologičeskogo instituta. 2022;(3):6-8 (In Russ.). Available from: https://elibrary.ru/item.asp?id=50398006
6. Zhong WQ, Chen G, Zhang W, Ren JG, Wu ZX, Zhao Y, et al. Epithelial-mesenchymal transition in keratocystic odontogenic tumor: possible role in locally aggressive behavior. Biomed Res Int. 2015;2015:168089. doi: 10.1155/2015/168089.
7. Al-Moraissi EA, Kaur A, Gomez RS, Ellis E 3rd. Effectiveness of different treatments for odontogenic keratocyst: a network meta-analysis. Int J Oral Maxillofac Surg. 2023;52(1):32-43. doi: 10.1016/j.ijom.2022.09.004
8. Mitropanova M. Мarkers of osteogenesis and bone resorption at different stages of surgical rehabilitation of children with congenital disorders of the face. Pediatric dentistry and dental prophylaxis. 2017;16(1):25-27 (In Russ.). Available from: https://www.detstom.ru/jour/article/view/38
9. Nesterova KI, Musienko AI, Musienko AA, Nesterova AA. Perforative odontogenic maxillary sinusitis: prerequisites for the formation and prevention through reparative osteogenesis growth factor. Russian otorhinolaryngology. 2014;(6):71-76 (In Russ.). Available from: https://elibrary.ru/item.asp?id=22813479
10. Dunaev MV, Kitaev VA, Motavkina MV, Druginin AE, Bubnov AS. Comparative analysis and clinical experience with osteoplastic materials materials based on non-demineralized bone collagen and artificial hydroxylapatite at the close of bone defects in ambulatory surgical dentistry. Annals of the Russian academy of medical sciences. 2014;69(7-8):112-120 (In Russ.). doi: 10.15690/vramn.v69i7-8.1117
11. Rakhimov ZK, Chirgaliyev MZh, Pulatova ShK. Enhancement treatments of methods of radikular cysts of jaw. Biologiya i integrativnaya medicina. 2019;2(30):5-15 (In Russ.). Available from: https://elibrary.ru/item.asp?id=41474308
12. Musienko AI. Stimulation of reparative osteogenesis by growth factor in the treating recession of gum. Ural Medical Journal. 2009;(5):55-58 (In Russ.). Available from: https://elibrary.ru/item.asp?id=12885783
13. Dmitrieva LA, Mkrtumian A.M., Atrushkevich VG. Mineral bone density and mineral exchange status in patients with chronic generalized periodontitis. Stomatologiia (Mosk). 2009;88(6):24-28 (In Russ.). Available from: https://elibrary.ru/item.asp?id=13332534
14. Badalyan KYu, Zedgenidze AM. Comparative analysis of materials for retrograde filling, performed on distant teeth in liquid and dry environments. Endodontics today. 2018;(1):59-62 (In Russ.). doi: 10.33029/9704-6001-6-SUR-2020-1-408
15. Kalmantaevaa OV, Firstova VV, Grishchenko NS, Rudnitskaya TI, Potapov VD, Ignatov SG. Antibacterial and immunomodulating activity of silver nanoparticles on mice experimental tuberculosis model. Applied biochemistry and microbiology. 2020;56(2):190-197 (In Russ.). doi: 10.31857/S0555109920020087
16. Fedotova YuM, Firsova IV, Mikhalchenko VF, Mikhalchenko DV. Comparative assessment of materials used for the conservative treatment of early forms of pulpitis and deep caries. Crimean Journal of Internal Diseases. 2017;(1):52-55 (In Russ.). Available from: https://crimtj.ru/Journal.files/32-2017-1/JOURNAL-2017-1.pdf
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For citations:
Musienko AI, Nesterova KI, Mikhailovsky SG, Musienko IS, Lipatova AV. Proprietary surgical approach to the treatment of large radicular cyst with retrograde filling of resected root canals: a clinical case report. Parodontologiya. 2024;29(4):465-471. (In Russ.) https://doi.org/10.33925/1683-3759-2024-1018
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