The Surgery We are going to watch today is Enuleation of Radicular Cyst There can be many types of cysts in the Oral cavity Radicual Cyst is the one, which is usually associated with Dead teeth, ..or grossly carious teeth or Teeth with history of trauma. From there it develops periapical infection, then it forms granuloma, ..And finally it transforms into a cyst (Marked area in this OPG Xray) Now, the Surgical procedure This cyst is located in the maxilla, So, we approached intra-orally The mucosa is being reflected in upward direction This reflection process is similar to the process of egg shell removal. We can see a white, glossy, fluid filled mass here, That is the Cystic mass And it is formed following the death of pulp of the affected teeth Thats why, this is definitely a Radicular Cyst There are many other cysts like Odontogenic keratocyst, ..Dentigerous cysts and many others.
Sometimes some tooth couldn't erupt on appropriate time in the right place, Then it can form Dentigerous Cyst. In this case of Radicular Cyst, ..We are removing this cyst very carefully like an egg shell, We can see, Gauges are being used to soak out the blood from the site, And very carefully,the enucleation process is going on, In maxilla, we know there is maxillary sinus, Which is an air-filled space, And because of its presence sometimes, when Radicular cyst... ...Develops in maxilla,it can grow bigger & coincide with maxillary sinus. It can touch the sinus lining So, we should remove the cyst with caution,to keep the lining intact And separate the cystic lining from the Sinus lining.
Sometimes the sinus lining gets leaked, But thats not a huge problem either. Nevertheless We should remove the cystic lining very carefully.. Then, we should close the area properly by stitching. Which is called "Water Tight Seal".
Now we can see, there is a very thin lining of maxillary sinus under the cyst From which the cystic lesion is being separated meticulously. And the Dead teeth will also be extracted. And after extraction, the remaining rough alveolar bone will be smoothened. We can see the tooth is being extracted with the help of elevator, ..And the cystic mass is being excised as well. And Now in maxilla, we can also notice that, ..The thin Sinus lining is moving along with the breathing movement. That means,this cyst was very close to the Maxillary Sinus. Thats why it was excised very carefully. And yes, that's the thin Sinus lining.
Now we will Irrigate this area before closure, And now we can see the whole excised cystic mass. Cysts are not cancerous lesions And these Surgeries can be done under local anaesthesia Here we can see the area is being closed properly by suturing Usually we remove these stitches after 7 days. After removal of stitch, the affected area becomes normal.
And if the patient maintains good oral Hygiene, No marks will be left there, ..Like we are watching right now, ...That the area is healed properly And it even looks like, no surgery was done there. And since Cyst is a benign lesion, not cancerous, So, there's nothing to fear actually. Timely Surgery is the best option. Thanks everyone for watching this video .
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