Abstract | Cista je naziv za patološku šupljinu karakteristične građe. Sastoji se od dvije ovojnice – unutarnje epitelne i vanjske vezivne. Svojim rastom cista stvara šupljinu koja može biti ispunjena vodenastim, kašastim ili plinovitim sadržajem. Ciste čiji je nastanak povezan sa zubom nazivamo odontogene i njih je Svjetska zdravstvena organizacija (SZO) klasificirala u dvije velike skupine
na temelju patohistološke građe i etiologije. Tako razlikujemo razvojne i upalne odontogene ciste. Glavni otežavajući faktor postavljanja rane dijagnoze jest činjenica da ciste ne uzrokuju pojavu simptoma sve dok svojim rastom ne deformiraju okolne anatomske strukture ili dok se ne pojavi upala. Iz tog se razloga najčešće dijagnosticiraju slučajnim radiološkim nalazom. Metode
postavljanja dijagnoze uključuju anamnezu, klinički pregled, radiološke pretrage, analizu punktata te za konačnu potvrdu, patohistološku analizu uzorka tkiva. Odontogene ciste uklanjaju se kirurški, a odabir metode ovisi o veličini, lokalizaciji i vrsti ciste te o općem stanju i dobi pacijenta. Ciste manjeg promjera uklanjaju se kompletnim izljuštenjem, tzv. enukleacijom ili metodom Partsch II. Velike ciste mogu se otvarati u okolne anatomske prostore s kojima su u bliskom kontaktu poput vestibuluma, sinusne ili nosne šupljine. Danas je najšire prihvaćena dvofazna kirurška tehnika kojom se najprije nastoji smanjiti početni volumen ciste do razine kada se može u potpunosti izljuštiti metodom enukleacije kako bi zaostali koštani defekt bio što manji. |
Abstract (english) | A cyst is pathological cavity made of characteristic tissues. It consists of two involucres – inner epithelial one and external binder one. As it grows, the cyst creates a cavity, which can be filled in with watery, mushy or gaseous content. Cysts occurring in connection with a tooth are called odontogenic cysts, and the World Health Organisation divides them into two large groups - developmental and inflammatory cysts - based on their histopathological constitution and etiology. The main aggravating factor in early diagnosis is the fact that cysts don't cause symptoms until they start deforming surrounding anatomical structures with their growth, or until inflammation occurs. Because of that, they are mostly diagnosed by accidental radiological finding. Methods of diagnosis include: anamnesis, clinical examination, radiological examinations, punctate analysis and, for the final confirmation, pathohistological analysis of tissue sample. Odontogenic cysts are removed surgically, and method selection depends on the size, localization and the type of cyst, and also on the patient’s age and general condition. Cysts of smaller diameter are removed by complete exfoliation, also known as enucleation or Partsch II method. Large cysts can open into the surrounding anatomical spaces that they are in close contact with, like vestibule, sinus or nasal cavity. Today, the most widely accepted two-stage surgical technique is to first try to reduce the initial volume of the cyst to a level where it can be completely exfoliated by the enucleation method, keeping the remaining bone defect as small as possible. |