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Introduction. Various odontogenic and nonodontogenic cysts can occur either in the upper or
lower jaw, these entities are an important chapter of the oral and maxillo-facial pathology.
Treatment methods for cystic lesions depends on the size, location, patient age, as well as
proximity to vital structures such as teeth, inferior alveolar canal, and maxillary sinus. Radical
treatment may be associated with numerous complications, such as facial deformity, missing
teeth, infection of bone graft, and numbness if during surgery the nerve is harmed. Conservative
treatment, such as decompression is recommended in case of large cysts or when it contains vital
structures.
Aim of the study. The aim of this study is to assess the effectiveness of decompression using the
CAD/CAM technology in comparison to traditional analogue methods by measuring cystic
lesion volume changes using computed tomography.
Materials and methods. This study was axed on 4 patients, 2 of them had undergone traditional
decompression for a cystic lesion of the jaw at the Department of Oral and Maxillofacial
Surgery, and in 2 cases a CAD/CAM decompression device was fabricated at the SRL. „OMNI
DENT”, study was conducted between 2015 and 2017. CT scans were taken in all patients before
and after decompression at 3 and 6 months. Each scan was analyzed to evaluate the volume changes of cystic lesions to determine the time of enucleation, by using the threshold method,
each cyst was virtually segmented.
Results. In all 4 cases semi-automatic virtual segmentation of the cystic lesion, was performed.
The duration of decompression ranged from 6 to 24 months. The reduction rates of cystic lesions
in analogue group ranged from 39,64% to 87,23% with a mean of 63,43%, and in CAD/CAM
group ranged from 60,47% to 98,32% with a mean of 79,39%.
Conclusions. Even though traditional analogue methods have shown good results in reduction
rates of cystic lesions, CAD/CAM is a subject of significant interest in the last years, which had
shown promising results. The main advantages include the possibility to obtain a patient specific
implant with increased precision which is less invasive with fewer surgical procedures, but
further studies are necessary in order to confirm this statement. |
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