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。     

颌骨牙源性囊肿袋形术/减压术引流装置的设计与临床应用

颌骨牙源性囊肿是一组来源于与牙发生相关组织的病变，上皮衬里的囊腔包含液体或半流体。由于囊腔内的压力、骨吸收因子释放及上皮增生引起囊肿不断增大，导致颌骨膨隆、牙松动移位，面部畸形及咬合功能障碍。牙源性囊肿的袋形术/减压术是一种简单易行而有效的保守性治疗方法。成功的治疗需要术后采用不同引流装置保持囊肿引流。较大的囊肿常在术后配戴囊肿塞或阻塞器，而较小的病变则通过减压管保守引流。大多数病例是在袋形术/减压术后囊肿缩小时二期行囊肿刮除术，可减少邻近结构的损伤或手术并发症，仅少数病例中袋形术作为惟一的治疗方式。文章简要介绍了袋形术/减压术的相关治疗机制以及多种引流装置的设计与临床应用。     

颌骨牙源性囊肿袋形术/减压术引流装置的设计与临床应用

 颌骨牙源性囊肿是一组来源于与牙发生相关组织的病变，上皮衬里的囊腔包含液体或半流体。由于囊腔内的压力、骨吸收因子释放及上皮增生引起囊肿不断增大，导致颌骨膨隆、牙松动移位，面部畸形及咬合功能障碍。牙源性囊肿的袋形术/减压术是一种简单易行而有效的保守性治疗方法。成功的治疗需要术后采用不同引流装置保持囊肿引流。较大的囊肿常在术后配戴囊肿塞或阻塞器，而较小的病变则通过减压管保守引流。大多数病例是在袋形术/减压术后囊肿缩小时二期行囊肿刮除术，可减少邻近结构的损伤或手术并发症，仅少数病例中袋形术作为惟一的治疗方式。文章简要介绍了袋形术/减压术的相关治疗机制以及多种引流装置的设计与临床应用。     

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。     

55例牙源性颌骨囊肿治疗体会

目的：总结牙源性颌骨囊肿的诊断和治疗方法。方法：回顾分析55例经病理诊断为牙源性颌骨囊肿病例的临床资料和手术方法。结果：55例牙源性颌骨囊肿中28例经囊肿刮除术术后无复发;25例袋形术病例中有11例在局麻下行二期刮除术后痊愈;2例行颌骨节段切除术和同期骨移植术修复,无复发,无排异反应。结论：牙源性颌骨囊肿早期确诊非常重要,正确的手术方法可提高临床疗效和有效保存患者颌骨的生理功能。     

囊肿塞在颌骨囊肿袋形术后引流中的应用

目的:介绍2种囊肿塞的设计和制作特点及其在囊肿袋形术后引流中的应用。方法:根据囊肿的部位和治疗要求不同,将囊肿塞分为常规型和义齿型,分别介绍制作步骤和注意事项。结果:依囊肿造口所在区域统计,43件囊肿塞用于磨牙区32件,前磨牙区7件,前牙区4件。常规型35件,义齿型8件。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。义齿型囊肿塞具有美学和功能效果。结论:卡环固位的囊肿塞适用于颌骨囊肿的引流,义齿型囊肿塞还可以暂时修复失牙。     

牙源性角化囊肿手术对咀嚼效能的影响

目的：评价下颌骨牙源性角化囊肿手术及可摘部分义齿修复对患者咀嚼效能的影响。方法：通过临床检查和复习X线片明确术前囊肿累及的牙数和术后的缺失牙数,采用吸光度法测定咀嚼效率。对结果进行比较和统计学分析。结果：手术后的平均失牙数下颌骨部分切除术组明显多于囊肿剜除术组和袋形术组;可摘部分义齿修复前及修复后的吸光度值,颌骨切除术组均低于囊肿剜除术和袋形术组（P〈0．01）;囊肿剜除术和颌骨切除术组义齿修复后吸光度值明显提高（P〈0．01）。结论：下颌骨牙源性角化囊肿手术后患者咀嚼效能变化与手术方法或牙缺失数有关。术后可摘部分义齿修复可明显改善患者的咀嚼功能。     

牙源性角化囊肿袋形术后的骨形成与改建

目的：本研究的目的是评价颌骨牙源性角化囊肿袋形术后骨形成的特点。方法：65例牙源性角化囊肿患者采用袋形术治疗。术后第3和第6个月分别进行临床、x线检查。病变范围广泛或曲面体层片上显示骨皮质破坏的患者补充CT检查。评估囊肿大小、皮质板穿通、下颌管的连续性、囊内牙移位及患区骨密度变化等。结果：在术后3个月,皮质板破坏区的骨连续性重新建立,下颌管的连续性部分恢复,变形的下颌骨呈现改建。囊内含牙随着囊肿的缩小而发生位移或部分萌出。曲面体层片显示,囊肿区骨密度值不断增加,术后3个月46．07％,术后6月达到64．69％。结论：牙源性角化囊肿袋形术后头3个月患区骨再生较快,一部分解剖形态恢复,此后新骨形成相对较慢,骨改建仍在进行。     

袋形手术治疗牙源性颌骨囊肿28例临床报告

目的：观察袋形手术治疗牙源性颌骨囊肿的临床效果。方法：复习28例病人的临床资料、X线资料及手术方式。结果：28例患者采用了袋形术进行治疗，并随访1～5年均取得了较为满意的效果。结论：袋形术手术方式成熟，创伤小，根据囊肿的大小、忠区牙齿及囊内含牙的特点选择不同的处理方式，可有效地保持颌骨的连续性及保留牙齿。     

应用袋形术联合囊肿塞治疗大型颌骨囊肿临床疗效分析

目的:评价袋形术治疗颌骨囊肿的临床应用。方法:收集2007—2016间来我院就诊,并采用袋形术治疗的大型颌骨囊肿患者39例,术后随访1～3年,对术后治疗效果进行评价、分析。结果:35例患者术后3～6个月X线片示骨腔缩小,骨密质增强;30例患者术后12个月骨腔逐渐消失;9例患者术后1年骨腔缩小,行囊肿刮治术,术后3～6个月伤口愈合良好,囊腔消失。结论:袋形术是一种简单、有效的治疗大型颌骨囊肿的方法,手术创伤小,减少了对重要结构的损伤,最大限度地保存牙齿,维持颌面部外形和功能。     

囊肿塞在颌骨囊肿开窗减压术中的应用

囊肿塞是颌骨囊肿进行开窗减压术治疗中常用的辅助治疗器具,近年来,随着材料和技术的发展,不同形式的囊肿塞层出不穷。本文回顾了目前临床常见囊肿塞的种类、制作方法及其适应证,探讨了各类囊肿塞在制作及应用过程中的优缺点。     

颌骨大型牙源性囊性病变的微创治疗

目的探讨袋成形术联合应用阻塞器治疗颌骨大型牙源性囊性病变的临床效果。方法颌骨大型牙源性囊性病变患者36例,采用袋成形术联合应用阻塞器治疗,术后3、6、12个月复诊,行临床检查及拍摄X线曲面断层片,记录囊腔影像面积变化,术后6~12个月对仍存留的囊肿行Ⅱ期囊肿刮切术。结果 36例患者术后3~6个月面部膨隆畸形均基本消失或完全消失,无1例患者出现伤口感染;10例患者囊腔体积缩小大于90%,24例囊腔体积缩小率达到80%~90%,2例囊腔体积缩小在60%以上;Ⅱ期囊肿刮切术后继续随访1年囊肿无复发,形态功能均恢复良好。结论袋成形术联合应用阻塞器治疗颌骨大型囊性病变,可改善患者颌骨膨隆畸形,最大程度保留颌骨解剖结构及生理功能,疗效肯定。     

Range and demographics of odontogenic cysts diagnosed in a UK population over a 30-year period

BACKGROUND: The aim of this study was to determine the range of all histologically diagnosed odontogenic cysts along with age range, sex distribution and site of presentation over a 30-year period. METHODS: All entries for odontogenic cysts occurring during 1975-2004 inclusive were retrieved and analysed for demographic data. RESULTS: A total of 55,446 specimens were received, of these 7121 (12.8%) specimens were diagnosed as odontogenic cysts. Radicular cyst was the most common diagnosis (52.3%), followed by dentigerous cyst (18.1) and odontogenic keratocysts (11.6%). CONCLUSIONS: Our study provides demographic data on a large series of odontogenic cysts in a European population. This is one of the largest series reported to date. Cysts such as the paradental cyst have a predilection for certain ages, sexes and sites. Odontogenic keratocysts and glandular odontogenic cysts have a marked propensity to recur as well as behave aggressively. It is essential that such lesions are detected as early as possible to minimize any necessary surgery.     

The prevalence of inflammatory and developmental odontogenic cysts in a Jordanian population: a clinicopathologic study.

OBJECTIVE: To determine the prevalence of odontogenic jaw cysts in a Jordanian population and to compare these data with previously published reports from other geographic areas. METHOD AND MATERIALS: The files on odontogenic jaw cysts treated between 1989 and 2001 in the Oral and Maxillofacial Pathology Diagnosis Service at the Department of Oral Medicine and Oral Surgery, Faculty of Dentistry, Jordan University of Science and Technology, were reviewed. Clinical and radiographic data were recorded and microscopic slides evaluated according to the most recent World Health Organization classification. Cases were analyzed with regard to age, sex, and anatomic site. RESULTS: A diagnosis of odontogenic jaw cyst was established in 654 patients, with a male-to-female ratio of 1.7:1. Radicular cyst was the most common type of odontogenic cyst found (41.7%), followed by dentigerous cysts (24.8%). The peak age affected was between the third and fifth decades. Both jaws were almost equally affected. The most common anatomic site of incidence was the maxillary incisor/canine region, followed by the mandibular molar region. CONCLUSION: This study indicates that there are some geographic differences with regard to the relative frequency, sex, and anatomic distributions of odontogenic cysts.     

Evaluation of collagen in connective tissue walls of odontogenic cysts –A histochemical study

J Oral Pathol Med (2011) 40 : 257–262 Background: The purpose of this study was to evaluate the nature of collagen in the connective tissue walls of odontogenic cysts, like the odontogenic keratocyst (OKC), dentigerous cyst and radicular cyst using picrosirius red stained sections. Furthermore, it was intended to assess if the capsular connective tissue can affect the nature of overlying epithelium, thus emphasizing the role of epithelial–mesenchymal interactions in biological behaviour of the cysts. Materials and method: The material for the study included 51 formalin‐fixed paraffin‐embedded tissue blocks (15 odontogenic keratocyst, 15 dentigerous cysts, 15 radicular cysts and four normal mucosa and two dental follicular tissue as controls), retrieved from the Department of Oral Pathology and Microbiology, MCODS, Manipal. Tissue blocks were sectioned at 5‐μm thickness, stained with picrosirius red stain and observed with polarization and light microscopy. Results: Few sections of OKC and dentigerous cyst exhibited greenish‐yellow birefringence in sub‐epithelial region, whereas others showed a yellowish‐orange birefringence under polarization microscopy. Most radicular cysts had yellowish‐orange to orange birefringence. Shift in colour in case OKC and dentigerous cyst was attributed to the presence of inflammation in those sections. These regions also exhibited either a change in phenotype or thickness of overlying epithelium. Conclusion: This technique can be used to study the nature of collagen fibres in odontogenic cyst walls. Further studies with an increased sample size and using various epithelial and mesenchymal markers and ssDNA antibodies should be carried out to confirm the effect of epithelial–mesenchymal interactions on the nature of epithelium of odontogenic cysts.     

Accuracy of computer-aided image analysis in the diagnosis of odontogenic cysts: A systematic review

Background This study aimed to search for scientific evidence concerning the accuracy of computer-assisted analysis for diagnosing odontogenic cysts. Material and Methods A systematic review was conducted according to the PRISMA statements and considering eleven databases, including the grey literature. Protocol was registered in PROSPERO (CRD 42020189349). The PECO strategy was used to define the eligibility criteria and only studies involving diagnostic accuracy were included. Their risk of bias was investigated using the Joanna Briggs Institute Critical Appraisal tool. Results Out of 437 identified citations, five papers, published between 2006 and 2019, fulfilled the criteria and were included in this systematic review. A total of 5,264 images from 508 lesions, classified as radicular cyst, odontogenic keratocyst, lateral periodontal cyst, glandular odontogenic cyst, or dentigerous cyst, were analyzed. All selected articles scored low risk of bias. In three studies, the best performances were achieved when the two subtypes of odontogenic keratocysts (solitary or syndromic) were pooled together, the case-wise analysis showing a success rate of 100% for odontogenic keratocysts and radicular cysts, in one of them. In two studies, the dentigerous cyst was associated with the majority of misclassifications, and its omission from the dataset improved significantly the classification rates. Conclusions The overall evaluation showed all studies presented high accuracy rates of computer-aided systems in classifying odontogenic cysts in digital images of histological tissue sections. However, due to the heterogeneity of the studies, a meta-analysis evaluating the outcomes of interest was not performed and a pragmatic recommendation about their use is not possible. Key words:Computer-assisted diagnosis, computer-assisted image analysis, computer-assisted image processing, odontogenic cysts, keratocysts, radicular cysts.