自制囊肿引流管治疗巨大下颌骨囊性病变的临床疗效及应用体会

目的:评价使用自制囊肿引流管在治疗下颌骨巨大囊性病变开窗减压术中的疗效.方法:选取12例下颌骨巨大囊性病变患者经自制囊肿引流管开窗减压术治疗,减压术后引流期维持6～20个月,测量减压术后病灶直径,评价临床疗效.所有患者均行二期囊肿刮治手术.术后随访12～60个月.结果:影像学结果显示,开窗减压术后3个月,囊肿周围骨质出...     

开窗减压术联合刮治术治疗下颌骨大型牙源性角化囊性瘤

目的 观察对下颌骨大型牙源性角化囊性瘤采用一期开窗减压术联合二期刮治术术后骨腔的影像学改变,探讨该术式的可行性.方法 下颌骨大型牙源性角化囊性瘤16例,进行一期开窗减压术联合二期刮治术治疗,定期复查曲面断层X线片,观察骨腔的改变.结果 经过8～16个月的观察,所有患者一期手术后病变骨腔逐渐向开窗部位缩小,骨腔密度逐渐增高,最终在开窗部位形成小骨腔;二期手术后约3个月,病变区骨密度与正常下颌骨一致.随访3～8年,所有病例均未见复发.结论 一期开窗减压术联合二期刮治术是治疗大型下颌骨牙源性角化囊性瘤的可行术式.     

开窗联合刮治术治疗领骨大型囊性病变的临床分析

目的 探讨开窗联合刮治术治疗领骨大型囊性病变的临床疗效.方法 采用一期开窗术联合二期刮治术治疗51例颌骨大型囊性病变患者,随访并评价疗效.结果 开窗术后6～8个月,51例患者囊腔明显缩小,有大量新生骨质沉积,无1例感染;二期刮治术后继续随访2年以上,3例复发,复发率为5.88%.结论 开窗联合刮治术治疗大型领骨囊性病变...     

下颌骨大型囊性病变开窗减压治疗的临床观察

目的:通过开窗减压术治疗下颌骨大型囊性病变,探讨其在下颌骨功能性外科中的应用价值。方法:34例下颌骨大型囊性病变患者采用开窗减压术治疗,术后随访12个月以上,通过临床和影像学检查评价治疗效果。结果:34例病例术后随访1⁹年。11例囊腔基本完全消退未进行二期处理,23例囊腔显著缩小行二期刮治手术。所有病例形态功能恢复良好无复发。结论:开窗减压术治疗下颌骨大型囊性病变,是保存下颌骨形态及功能的有效方法。     

开窗减压术联合囊肿塞治疗青少年大型下颌骨囊肿的临床研究

目的观察开窗减压术联合囊肿塞治疗青少年大型下颌骨囊肿的疗效。方法对21例青少年大型下颌骨囊肿患者行开窗减压联合囊肿塞治疗,术后随访1~4年,观察不同时期囊腔体积变化以及受累牙手术前后牙髓活力的变化情况。结果应用CBCT测量囊腔体积变化情况,术后囊腔体积明显缩小,以术后6个月内缩小速度最快;术后12月较术后6月囊腔体积虽然仍有缩小,但两个时间点囊腔体积无统计学差异。开窗减压术后,术后6月牙髓活力略降低,但与术前相比较,两者差异无统计学意义。结论青少年大型颌骨囊肿应积极应用开窗减压术治疗,效果显著,并且有利于囊腔波及牙齿的牙髓活力的保留。开窗后6月到12月期间要密切关注囊腔骨质新生情况,对于囊腔变化放缓的患者要分析原因及时跟进二期囊肿刮治术。     

开窗刮治术治疗24例下颌骨实性成釉细胞瘤效果观察

目的 观察下颌骨实性成釉细胞瘤一期刮治开窗术结合二期刮治术的临床效果,探讨该术式治疗下颌骨实性成釉细胞瘤的可行性。方法 筛选24例下颌骨单房或多房实性肿瘤患者,术中明确诊断为成釉细胞瘤后,进行一期开窗刮治。术后定期随访颌面部CT、全景片,适时行二期刮治。观察囊腔变化,分析治疗效果。结果 24例患者中,无肿瘤进展、范围增大病例,均未出现开窗口早闭、局部感染或骨髓炎症状。其中病情稳定6例,部分缓解10例,完全缓解8例,总有效率为75.0%。20例患者经二期刮治术,术后随访12~24个月,未见肿瘤复发。结论 开窗刮治治疗下颌骨实性成釉细胞瘤具有可行性,但应严格掌握手术适应证。     

开窗联合刮治术治疗颌骨大型囊性病变的临床分析

目的探讨开窗联合刮治术治疗颌骨大型囊性病变的临床疗效。方法采用一期开窗术联合二期刮治术治疗51例颌骨大型囊性病变患者,随访并评价疗效。结果开窗术后6～8个月,51例患者囊腔明显缩小,有大量新生骨质沉积,无1例感染;二期刮治术后继续随访2年以上,3例复发,复发率为5.88%。结论开窗联合刮治术治疗大型颌骨囊性病变可以兼顾面部外形和颌骨功能,为一种实用有效的临床治疗方法。     

内窥镜辅助下精准微创刮治术治疗下颌骨大型牙源性角化囊肿效果观察

目的:观察下颌骨大型单房或多房牙源性角化囊肿在内窥镜辅助下行精准微创刮治术后的临床效果。方法:17例下颌骨大型单房或多房的牙源性角化囊肿患者，在内窥镜辅助下口内切口行微创刮治。术后定期随访，观察囊腔和颜面部变化，分析治疗效果。结果:17例患者术后随访14～36个月，无囊腔范围增大，无局部感染发生。其中完全恢复14例，稳定无进展3例，总有效率达100%。17例患者，均未行二期手术，未见囊肿复发。结论:内窥镜辅助下精准微创刮治术治疗下颌骨大型牙源性角化囊肿具有可行性和优越性。     

负压吸引联合刮治术治疗牙源性颌骨角化囊肿17例分析

目的评估负压吸引联合刮治术对牙源性颌骨角化囊肿的治疗效果。方法选择近七年我科就诊的17例波及范围较大的颌骨角化囊肿患者,采用囊肿局部开窗负压吸引术进行治疗,术后随访观察2、4、6、12个月,对仍存留的颌骨囊肿行二期囊肿刮治术。结果术后2月,4例囊腔完全消失,囊腔体积缩小平均比率为65%;术后4月,11例囊肿囊腔缩小在75%以上,同期给予了刮治术;术后6月,其余2例缩小平均比率在80%以上,给予囊肿刮治术。所有病例平均治疗时长3.76个月。结论采用负压吸引联合刮治术,可有效治疗颌骨角化囊腔、缩短治疗时长。     

开窗术保留颌骨囊肿非病灶牙的临床分析

目的:评价用开窗术治疗颌骨囊肿时保留非病灶牙正常牙髓活力的疗效分析.方法:选取2017—2018年于我科就诊的大型颌骨囊肿16例.术前评估囊肿内非病灶牙的牙髓活力,予以开窗引流术治疗,开窗术后2周～12个月对患者进行随访,评估囊肿内非病灶牙的牙髓活力;待囊肿变小后行刮治术,术后再次评估非病灶牙的牙髓活力.结果:16例颌骨大型囊肿涉及非病灶牙68颗,术后牙髓活力保留的牙为60颗,对8例牙髓坏死的牙进行完善根管治疗后行烤瓷冠修复.结论:开窗引流术治疗大型颌骨囊肿,损伤小,发生颌骨骨折的可能性低,而且对囊肿涉及非病灶牙的牙髓保护有明显疗效.     

带环唇弓囊肿塞治器在下颌骨囊肿开窗减压术中的应用

目的:探讨带环唇弓囊肿塞治器在下颌骨囊肿开窗减压术治疗中的临床应用。方法:在7例下颌骨牙源性囊肿开窗减压术中,利用带环唇弓固定引流塞治器的制作方法及戴入后治疗效果的观察。结果:利用带环唇弓固定引流塞治器后,囊肿开窗引流口始终保持通畅,未发现与该装置应用有关的明显并发症。结论:带环唇弓塞治器可用于作为颌骨开窗引流术后保持引流口通畅的一种较好的治疗装置在临床中应用。     

3D打印负压引流囊肿塞在下颌骨囊性病变开窗减压术后应用效果研究

目的    设计一种3D打印的具有负压引流功能的囊肿塞,评价其在下颌骨囊性病变开窗减压术后应用的临床效果。方法    选取2018年8月至2019年12月于西南医科大学附属医院口腔颌面外科、泸州市人民医院口腔科就诊的下颌骨囊性病变患者18例,随机分为3D打印组和传统组,每组9例。所有患者均采用开窗减压术治疗,3D打印组使用3D打印的负压引流囊肿塞,传统组使用传统义齿型囊肿塞。术后1、3、6个月,评价两组患者主观评价指标、囊腔体积缩小率及囊腔长径变化情况。结果    术后1个月,对两组患者的主观评价指标进行比较分析发现,相较于传统组,3D打印组患者对囊肿塞的舒适性评价较高,且认为更易清洁囊腔,差异有统计学意义（均P < 0.05）;两组患者对囊肿塞的固位性和使用便利性评价比较,差异无统计学意义（均P > 0.05）。术后3、6个月,3D打印组囊腔体积缩小率均大于传统组,差异均有统计学意义（均P < 0.05）;但两组囊腔长径变化量比较,差异均无统计学意义（均P > 0.05）。结论    3D打印负压引流囊肿塞小巧舒适,清洁囊腔效果好,能够加速囊腔缩小,建议在颌骨囊性病变开窗减压术后应用。     

囊肿塞在颌骨囊肿治疗中的应用

目的 :探讨囊肿塞在袋形术后颌骨囊肿治疗中的临床价值。方法 :介绍了囊肿塞的制作、戴入后处理及 5例下颌骨牙源性囊肿的临床应用。结果 :所有病例中囊肿造口保持通畅 ,未发现与该装置应用有关的并发症。结论 :卡环固位的囊肿塞是大型牙源性囊肿袋形术后维持囊腔引流的一种较好装置。     

含牙囊肿致下颌第一恒磨牙垂直阻生的正畸治疗

目的探讨和评估含牙囊肿引起下颌第一恒磨牙严重阻生的正畸治疗方法和效果。方法对6例含牙囊肿引起垂直阻生的下颌第一磨牙进行外科开窗、囊肿刮除结合正畸牵引导萌。结果阻生第一恒磨牙被引导至正常位置,X线片示囊腔消失,腔内组织再生,病变的囊性组织为正常的骨组织所代替。完成时间平均为8个月。结论外科开窗、囊肿刮除结合正畸牵引治疗含牙囊肿可最大可能保存埋伏牙,消除囊腔,促使周围骨组织再生。     

Laser-assisted treatment of a dentigerous cyst: case report

Dentigerous cysts are benign maxillary odontogenic cysts associated with the crown of an unerupted tooth. They can expand the cortical bone to such an extent that they cause displacement of teeth and root resorption in the adjacent teeth. The purpose of this report was to describe the clinical case of a dentigerous cyst in a mandibular permanent molar of a 6-year-old child. The cyst caused the displacement of the bud of the permanent second molar and root resorption of the primary second molar. The cyst was treated by: (1) mucous fenestration using an erbium laser: (2) drainage of the fluid content; and (3) curettage of the bone cavity. The injury was successfully resolved in just 5 months with: (1) bone regeneration; (2) the repositioning of the displaced bud; and (3) correct eruption of the affected tooth.     

牛骨粉(Bio-Oss)/人工生物膜(海奥)联合治疗下颌骨缺损骨腔的临床观察

目的　　探讨下颌骨囊肿术中使用牛骨粉(Bio-Oss)/人工生物膜(海奥)联合治疗疗效。方法　选取下颌骨囊肿患者12例病例,囊肿摘除后,分成2组,1组骨粉填塞,并用生物膜覆盖,另1组不作处理。根据临床及影像学资料分析评估囊肿术后骨缺损处的骨质再生和改建情况。结果　骨粉/生物膜联合治疗组术后患者骨缺损区成骨较好。结论　下颌骨囊肿术后骨缺损使用骨粉/生物膜联合治疗,效果确切、可靠。     

Fate of mandibular canals displaced by enlarged cystic lesions: does the inferior alveolar neurovascular bundle relocate to its original position?

Our aim was to identify the positional changes of the inferior alveolar neurovascular bundle and evaluate the relocation of the displaced mandibular canal after enucleation of a cyst. Seventy patients (72 sites) who had had cysts enucleated were divided into three groups based on the degree of encroachment of the cystic lesion into the mandibular canal and whether a bone graft had been inserted after the cyst had been enucleated. The mean (range) of patients’ ages was 45 (18–75) years, and there were 29 male and 41 female patients. Group A comprised cysts with encroachment on the mandibular canal that were enucleated without a bone graft; Group B consisted of cysts with no encroachment of the mandibular canal, but were enucleated without a bone graft; and Group C comprised cysts with encroachment of the mandibular canal that were enucleated with a bone graft. The displacement of the mandibular canal was identified from analysis of computed tomographic (CT) images. Changes in the position of the mandibular canal were measured on panoramic radiographs. The mandibular canal was repositioned superiorly by a mean (SD) of 2.4 (1.65) mm after enucleation of the cyst, which was significant in Group A (p < 0.001), but not in Groups B and C. These results indicate that the displaced inferior alveolar neurovascular bundles that were not surrounded by bony canal tended to relocate towards a supposedly normal position, and after enucleation of the cyst the mandibular canal was remodelled in this new location. This tendency to relocate was blocked by bone grafting. Bone grafts are therefore recommended in cases where enough bony height is required for future insertion of implants.     

Paradental cyst: report of two cases

BACKGROUND: The paradental cyst is an odontogenic lesion of inflammatory origin that has few clinical signs and symptoms apart from recurring acute episodes. A well-defined radiolucency associated with the roots or distal to the crown may be seen radiographically. The purpose of this article is to report on different aspects of two cases involving paradental cysts. In the first case, the patient complained about recurring pericoronitis. A semilunar-shaped radiolucency on the distal aspect of the mandibular third molar was noted on the periapical radiograph. In the second case, the patient's main complaint was chronic trauma of the overlying mucosa. Radiographs revealed an enlarged pericoronal space. METHODS: In both cases, the mandibular third molar was extracted due to a lack of space. Lesional samples were sent for histopathologic analysis. RESULTS: In the first case, the drainage of cystic fluid and a regular concavity were found during tooth removal. In the second case, a nodular lesion was found adhering to the disto-buccal surface of the tooth arising from the distal wall of a periodontal pocket. The histopathologic analysis revealed a hyperplastic stratified squamous epithelium with arcading lining a fibrous capsule with inflammatory infiltrate, resulting in a final diagnosis of a paradental cyst. CONCLUSIONS: The presence of a paradental cyst should be considered when recurrent inflammatory periodontal processes are associated with partially erupted vital teeth, even when characteristic radiographic findings are absent. Definitive diagnosis requires a clinicopathologic correlation incorporating surgical, radiographic, and histologic findings.     

Unusual surgical approach in a bilateral case of mandibular buccal infected cyst

In the new edition of WHO's "Histological typing of odontogenic tumors", the mandibular infected buccal cyst, that is associated with the lower first or second permanent molars, is considered a paradental cyst as well as the inflammatory collateral cyst, which is usually related to the lower third molar. The lesion occurs on the buccal and lateral aspects of the roots of mandibular molars with vital pulp, at the eruption time, in children aged between 6 and 10 years. The inflammation is always present in these cysts and may have an important role in their pathogenesis because it stimulates hyperplasia and cystic change of the reduced enamel epithelium or the epithelial cell rests of Malassez. The authors report the case of a 7-year-old girl, in whom both first mandibular molars were affected by an infected buccal cyst. A different surgical approach was performed with marsupialization on the left side and cystectomy on the right side. The case reported here seems to be interesting because it is the second well documented case of bilateral mandibular infected cyst associated with unerupted molars and because the adopted treatment differs from the therapeutical approach suggested in the literature. A 6-year follow-up demonstrates a correct dental and bone evolution on both mandibular molar sides.     

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目的探讨开窗减压术治疗颌骨巨大囊性病变的临床应用价值。方法对2009年5月至2010年11月南方医科大学附属南海医院口腔科收治的8例颌骨囊性病变患者(包括1例根尖囊肿,1例含牙囊肿、5例角化囊肿、1例囊性成釉细胞瘤),经口内进行开窗减压,术后定期复诊,3个月复查曲面断层摄影,1年进行三维CT重建,测量术后囊腔缩小情况。结果 8例患者,最长的已观察18个月,最短的观察3个月,2例患者(包括1例根尖囊肿、1例成釉细胞瘤)囊腔完全消失,6例患者囊腔越来越缩小。结论开窗减压术是一种简便、经济、效果良好的治疗颌骨囊性病变的方法。