下颌骨囊肿保守治疗9例总结

目的:探讨保守治疗下颌骨囊肿的方法并评价其疗效。方法:选取9例直径为5～7.5cm的下颌骨囊肿,行囊壁摘除(或刮除)+拔牙术,术后囊腔以碘仿纱条填塞。对可疑角化囊肿者,则在摘除(或刮除)囊壁后再加石炭酸烧灼骨创。术后定期更换碘仿纱条,在遗留骨腔变浅或成碟形前每月进行临床、X线检查。术后1年时加摄一张X线片。所有病例术后随访1～3年,平均1.8年。结果:术后2～3月颜面畸形完全消除;术后1、3、6个月囊肿摘除(或刮除)后所遗留的骨腔面积分别平均缩小27.2%、63.8%和90.8%;下颌骨下缘和(或)升支部边缘新生骨厚度平均分别增加4.5、16.3、27.2 mm。术后1年原囊肿部位新生骨密度和正常骨组织一致。结论:该方法治疗下颌骨囊肿,可以保存下颌骨的连续性及囊肿邻近的重要组织结构,较快地消除颜面畸形、改善咬合关系、促进新骨生成,减少对颌骨发育的干扰和手术次数,尤其适用于对面容要求高的青少年患者。

Conservative Treatment of Mandibular Odontogenic Cysts: a Report of 9 Cases

Objective: To evaluate the methods and efficience in conservative treatment of mandibular odontogenic cysts.Methods: 9 patients with mandibular cysts of 5～7.5 cm were treated by surgical enucleation or curettage and tooth extraction concomitcantly Bone defects were filled with iodoform gauze.Cases which suspected as odontogenic keratocyst were treated with phenol cauterization additionally.Postoperative panoramic radiography and clinical examination were performed monthly until residual cavities became shallow or acetabuliform.all cases were checked by X-ray 1 year after operation.Results: Facial contour were appeared to normal at 2 to 3 months after treatment.Analysized by computer,the average reduction of residual cavities were 27.2%,63.8%,90.8% after 1,3,6 months respectively.The average thickness of regenerative bone of the mandibular or ramus were 4.5,16.3 and 27.2mm after 1,3,6 months respectively.The density of regenerative bone identical to normal bone appearance 1 year later.Conclusion: This conservation treatment of mandibular cysts could maintain the continuity of mandible,conserve adjacent vital structure,correct maxillofacial malformation soon,avoid disturbing the growth of the mandible and especially cases suitable to adolescent.