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17.04.2019 | Digitale Volumentomographie | CME Zahnärztliche Fortbildung

Odontogene Keratozyste – Ätiologie, Pathogenese und Therapie

verfasst von: Dr. Dr. M. Dau, B. Frerich

Erschienen in: wissen kompakt | Ausgabe 2/2019

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Zusammenfassung

Die odontogene Keratozyste (OKZ) wird – als zweithäufigster odontogener Tumor – häufig erstmals als radiologischer Zufallsbefund im Orthopantomogramm (OPT) bei klinischer Beschwerdefreiheit diagnostiziert. Die OKZ können auch nach Jahrzehnten noch Rezidive bilden. In seltenen Fällen ist auch eine Entartung der OKZ zu einem primär intraossären Plattenepithelkarzinom möglich. Neben dem OPT als zahnärztlichem Basisdiagnostikmittel können zusätzliche radiologische Untersuchungen wie die digitale Volumentomographie (DVT), Computertomographie (CT) und Magnetresonanztomographie (MRT) prätherapeutisch Informationen bzgl. Ausdehnung der Zyste und wichtiger anatomischer Nachbarstrukturen liefern, was v. a. im Bereich der Oberkieferfront hilfreich sein kann. Die Diagnosestellung erfolgt letztlich über die Histologie. Differenzialdiagnostisch ist das Ameloblastom abzugrenzen sowie auch an das Gorlin-Goltz-Syndrom zu denken. Das Gorlin-Goltz-Syndrom weist neben OKZ weitere Symptome wie multiple Basalzellkarzinome (BZK) auf und erfordert einen interdisziplinären Behandlungsansatz. Therapeutisches Mittel der Wahl beim OKZ ist die Enukleation mit Carnoy-Lösung, wobei der Stellenwert alternativer Behandlungsmethoden wie Enukleation mit Kryotherapie oder Enukleation mit modifizierter Carnoy-Lösung aufgrund von fehlenden Studien nicht bewertet werden kann. Der Einsatz der Carnoy-Lösung in Nervennähe kann zu Nervennekrosen und damit zu Nervenschädigungen führen. Die Marsupialisation sowie die alleinige Dekompression sind aufgrund der hohen Rezidivraten als obsolet anzusehen.

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Titel: Odontogene Keratozyste – Ätiologie, Pathogenese und Therapie
verfasst von: Dr. Dr. M. Dau
B. Frerich
Publikationsdatum: 17.04.2019
Verlag: Springer Medizin
Schlagwörter: Digitale Volumentomographie
Basalzellkarzinom
Kopf-Hals-Tumoren
Kryotherapie
Basalzellkarzinom
Orthopantomogramm
Kryotherapie
Basalzellkarzinom
Basalzellkarzinom
Digitale Volumentomographie - 1
Ameloblastom
Ameloblastom
Erschienen in: wissen kompakt / Ausgabe 2/2019
Print ISSN: 1863-2637
Elektronische ISSN: 2190-3816
DOI: https://doi.org/10.1007/s11838-019-0082-x

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Odontogene Keratozyste – Ätiologie, Pathogenese und Therapie

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