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...     

颌骨囊肿开窗治疗临床特征动态研究

目的: 观察下颌骨牙源性颌骨囊肿开窗减压后囊腔动态变化特征,探讨颌骨囊肿开窗减压治疗规律。方法: 收集2017年6月—2019年6月收治的下颌骨牙源性囊肿行开窗减压术的患者资料,采用回顾性分析,依据术前及术后拍摄的锥形束CT(CBCT),通过E3D建模软件三维重建,分析囊腔收缩方向、收缩速度及与年龄、时间的关系。采用SPSS 21.0软件包对数据进行统计学分析。结果: 下颌骨囊腔多沿最大直径轴向收缩,开窗后囊腔收缩呈椭圆状,囊腔收缩速度从小到大依次为角化囊肿、根尖囊肿、含牙囊肿。收缩速度与时间和年龄呈负相关;开窗12个月后,囊腔收缩速度明显减缓。结论: 开窗减压术治疗下颌骨牙源性囊肿的效果与时间、年龄和病理类型相关,建议根据囊腔变化特点,适时予以相应处理。     

低温等离子射频消融技术在牙源性角化囊性瘤治疗中的应用

目的:探讨低温等离子射频消融技术联合开窗减压术,治疗下颌骨牙源性角化囊性瘤的疗效。方法 :对16例病变范围>3 cm的下颌骨牙源性角化囊性瘤患者,采用低温等离子射频消融技术消融囊壁组织,并行开窗减压术,术后3、6、12月复查,观察复发率及囊腔缩小情况。结果 :16例下颌骨牙源性角化囊性瘤经低温等离子射频消融技术结合开窗减压术治疗后,均取得较好疗效,临床及影像学检查显示,囊肿周围骨质再生改建,囊腔逐渐缩小。随访时间10~28个月,随访期间未见复发。结论 :低温等离子射频消融技术治疗下颌骨牙源性角化囊性瘤具有简单、微创、并发症少等优势,是治疗下颌骨牙源性角化囊性瘤的一种安全有效的治疗方法。     

开窗减压术治疗下颌骨大型囊性病变的临床研究

目的:通过开窗减压术治疗下颌骨大型囊性病变,探索其在下颌骨保存性功能外科中的应用价值。方法:回顾1999年10月～2004年10月治疗的107例下颌骨大型囊性病变开窗减压术病例,测量开窗减压术后病灶长径的变化,随访观察复发情况,评价临床治愈率。结果:开窗减压术治疗下颌骨大型囊性病变的总有效率为87.85%,牙源性角化囊肿的疗效优于囊性成釉细胞瘤,其中单房型角化囊肿疗效优于多房型者,单房或多房型囊性成釉细胞瘤之间疗效没有统计上差异。结论:开窗减压术是治疗颌骨大型囊性病变的有效方法。     

减压术治疗青少年下颌骨大型角化囊性瘤的疗效分析

目的:探讨和评估减压术在青少年下颌骨大型牙源性角化囊性瘤治疗中的应用效果.方法:选择2005年2月-2011年2月15例下颌骨大型牙源性角化囊性瘤患者,平均年龄19.3岁,采用开窗减压术治疗,2～3个月定期随访,复拍全景片.6～12个月随访,复拍CT,囊肿直径缩小至2 cm左右时行二期囊肿刮除术.结果:减压期12～18个月,平均13.6个月.影像学显示囊肿周围新骨再生,平均囊肿缩小比例6个月时为41.5％,12个月时为61.5％,18个月时为81.8％.二期刮除术后随访1～5a,无复发病例.结论:减压术是治疗青少年下颌骨大型牙源性角化囊性瘤的首选方法.     

开窗减压术治疗大型牙源性角化囊性瘤的临床研究

目的 :探讨开窗减压术治疗颌骨大型牙源性角化囊性瘤的临床价值。方法 :对22例牙源性角化囊性瘤进行开窗减压术,定期随访,待囊腔直径缩小至1~2 cm或连续观察3个月无明显变化时,行二期囊肿刮除术。结果:开窗减压期为3~24个月,影像学显示囊腔周围新骨再生,颌骨形态改建。二期刮除术后随访6~48个月,无复发病例。结论:开窗减压术是一种安全、有效微创治疗颌骨大型牙源性角化囊性瘤的方法。     

开窗、负压吸引、刮治术治疗牙源性颌骨囊性病变的对比研究

目的:对比研究开窗减压术、负压吸引术、刮治术对牙源性颌骨囊性病变的临床疗效。方法:选取牙源性颌骨囊性病变30例,病变最大径>3.5 cm的20例患者进入甲组,并根据患者意愿分为甲组A(开窗减压)11例、甲组B(开窗负压吸引)9例;最大径<3.5 cm的10例患者进入乙组,根据患者意愿分为乙组A(开窗减压)5例和乙组B(手术刮治)5例。测量治疗过程中囊腔体积变化及曲面体层片缺损面积,比较囊性缺损缩小速度,应用SPSS 11.0软件包对病变范围的缩小情况量化后进行统计学分析。结果:甲组A开窗减压和甲组B负压吸引囊腔愈合良好,6个月后囊腔体积减少平均百分率为63.66%和83.52%,囊腔面积减少平均百分率为65.86%和88.65%,甲组B与甲组A有显著差异,P<0.05;乙组B一次手术刮治治疗组6个月后颌骨形态与结构基本恢复正常,有效率100%,乙组A有效率为60%。结论:负压吸引术较开窗减压术对大型牙源性颌骨囊性病变有更好的治疗作用,具有广阔的应用前景;小型牙源性颌骨囊性病变最好选择一次性手术刮治治疗。     

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.     

开窗减压术对下颌骨大型囊性病变的疗效及影响因素分析

目的 研究开窗减压术对不同类型下颌骨大型囊性病变的临床疗效及其影响因素.方法 通过曲面断层片测定开窗减压术前及术后6例含牙囊肿(dentigerous cysts,DC)、9例牙源性角化囊性瘤(keratocystic odontogenic tumors,KTOC)及10例单囊型成釉细胞瘤(unicystic ameloblastoma,UA)的面积,计算DC组、KTOC组、UA组囊腔的缩小速率,分析患者年龄、病变初始大小以及缩小速率之间的关系.结果 3种囊性病变开窗减压术后6个月囊腔面积变化分别为DC组60.73%±7.15%,KTOC组为60.99%±4.00%,UA组59.25%±6.81%,3组之间差异无统计学意义(F=0.225,P=0.800).DC组(R=0.94,P<0.01)、KTOC组(R=0.97,P<0.01)、UA组(P<0.01,R=0.99),3组囊腔初始面积与囊腔面积绝对减少速率的相关性有统计学意义;在KTOC组(P<0.01,R=0.86)和UA组(P<0.01,R=0.99)中囊腔初始面积与囊腔面积相对减少速率的相关性有统计学意义;在DC组(P<0.01,R=0.99)和KTOC组(P<0.01,R=0.99)中,患者年龄与囊腔面积相对减少速率之间的相关性有统计学意义.结论 开窗减压术对于不同类型的下颌骨大型囊性病变的疗效无明显差异,但是年龄和病损的初始大小可能与囊腔减小速率相关.     

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。     

开窗减压术治疗大型上颌窦牙源性囊性病变疗效评价

目的：评价开窗减压术治疗大型上颌窦牙源性囊性病变的疗效,为临床治疗提供参考。方法：回顾2011年1月—2020年12月于上海交通大学医学院附属第九人民医院口腔外科就诊的大型牙源性上颌窦囊性病变病例,采用开窗减压后二期刮治手术治疗,开窗后配戴塞治器,分为负压及非负压引流2种。应用Mimics定量测量病变体积变化,观察新骨改建、上颌窦炎症情况。采用SPSS 17.0软件包,通过配对t检验比较术前囊性病变和最终二期手术前囊性病变体积是否存在差异,通过成组t检验和卡方检验比较不同塞治器治疗效果。结果：20例患者纳入研究,负压及非负压引流各10例。开窗前囊性病变体积为(25 993.81±13 611.78)mm³,减压后最终体积为(5 386.30±3 546.30)mm³,体积缩小率为(77.54±13.01)%,缩小显著(P<0.001)。11例病变体积缩小>80%,9例介于50%～80%之间。非负压吸引组体积缩小率为(72.75±14.16)%,疗效优秀率40%;负压吸引组体积缩小率为(82.33±10.29)%,疗效优秀率70%,...     

Conservative treatment of large cystic lesions of the mandible: a prospective study of the effect of decompression

Our aim was to evaluate prospectively the effects of decompression as the primary treatment of large mandibular cysts, irrespective of their histological type. Twenty patients with large mandibular cysts completed treatment successfully. After a mean duration of decompression of 446 days, cysts had shrunk by a mean of 81%. Mean follow-up was 527 days after removal of the decompression stent and removal of the cyst. There were no recurrences. The advantages of this approach are simplicity, immediate gathering of information on the type of cyst with simultaneous start of treatment, low morbidity and low incidence of complications during treatment. Despite the length of the treatment, we recommend the use of decompression stents in the treatment of large mandibular cysts.     

A comparative study of odontogenic keratocysts associated with and not associated with an impacted mandibular third molar

OBJECTIVE: The purpose of this study was to compare odontogenic keratocysts associated with and not associated with an impacted mandibular third molar. STUDY DESIGN: Panoramic radiographs of odontogenic keratocysts associated with impacted mandibular third molars (15 cysts, associated group) were compared with radiographs of odontogenic keratocysts not associated with impacted mandibular third molars (25 cysts, nonassociated group). The radiographic images were analyzed with reference to the patients' age and sex. RESULTS: The mean age of patients in the associated group was lower than that of patients in the nonassociated group. The mean area of the cysts in the associated group was larger than that of those in the nonassociated group. The patients' ages did not significantly correlate to the areas of either kind of cyst. CONCLUSIONS: The odontogenic keratocysts in the associated group had a tendency toward rapid growth in the patients' youth.     

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。     

Decompression, enucleation, and implant placement in the management of a large dentigerous cyst

The dentigerous cyst is a developmental odontogenic cyst, accounting for 10% of all cysts of the jaws. The treatment options are decompression, marsupialization, or enucleation regarding the features of the lesions. In this article, a case of a 17-year-old adolescent girl having a large mandibular dentigerous cyst associated with an unerupted third molar is presented. The treatment is composed of decompression for 6 months and enucleation. Decompression and enucleation are a predictable choice in the treatment of large cysts. Radiologic evaluation is mandatory to decide for the appropriate time for the removal of the decompression stents, the enucleation time, and also for the evaluation of the adequate new bone formation for implant placement. The present case emphasizes the success of a conservative approach in the management of a large dentigerous cyst in a young patient and also the maintenance of the new bone formation without using any graft materials for the placement of dental implants.     

减压术治疗下颌骨大型牙源性角化囊肿的临床研究

目的：评价减压术治疗下颌骨大型牙源性角化囊肿的疗效。方法：回顾1999年10月至2004年10月61例经减压术治疗的下颌骨大型角化囊肿病例．随访6个月～5a，进行临床、影像学及病理学检查，在全景片上测量减压术后病灶的长径变化，评价临床疗效．随访观察复发情况：采用SAS6．12统计软件包进行X^2检验，计算Fisher确切慨率。结果：临床及影像学检查显示，囊肿周同骨质再生改建，囊腔逐渐缩小．被推移的下牙槽神经血管束恢复至正常位置，倾斜移位的牙长轴逐渐纠正减乐术后引流期维持6～23个月，中位时间14个月。减压术治疗颌骨大型角化囊肿的有效率为91．8％，单房型角化囊肿的疗效优于多房型，不同年龄组间的有效率在统计学上无显著差异。本组资料随访期间未发现复发。结论：减乐术是治疗下颌骨大型牙源性角化囊肿的有效方法。     

A radiologic analysis of dentigerous cysts and odontogenic keratocysts associated with a mandibular third molar

OBJECTIVE: The purpose of this study was to discriminate radiographically between dentigerous cysts (DCs) and odontogenic keratocysts (OKCs) associated with a mandibular third molar. STUDY DESIGN: The material consisted of panoramic radiographs of dentigerous cysts (44 patients, 45 cysts) and odontogenic keratocysts (15 patients, 16 cysts), all of which were related to a mandibular third molar. The radiographic images were analyzed with reference to the patients' ages and symptoms. RESULTS: The mean age of patients in the OKC group was less than that of patients in the DC group. The mean area of the cysts in the OKC group was larger than that of those in the DC group. The mean distance from the second to the third molar in the DC group was greater than that in the OKC group. Although there was a significant correlation between the area and distance in the DC and OKC groups, the patients' ages did not significantly correlate to the area and distance of either cyst. CONCLUSIONS: The OKCs had a tendency toward rapid growth in the patient's youth but short movement of a third molar compared with the DCs. The DCs and OKCs do not appear to develop gradually from the period when follicles or dental lamina were formed but arise at various periods randomly.     

Volume reduction of cystic lesions after surgical decompression: a computerised three-dimensional computed tomographic evaluation

Objectives

This study was performed to evaluate the three-dimensional radiographic variation in mandibular odontogenic cystic lesions after decompression.

Materials and methods

Pre- and post-decompression computed tomography (CT) evaluations in 20 patients affected by keratocysts (n?=?10), dentigerous cysts (n?=?9) and ameloblastoma (n?=?1) were analysed using software designed for three-dimensional measurement of volumes; the results were correlated with treatment duration, age, sex and histological type.

Results

The mean (range) decompression time was 5.70 (3–12)?months. The mean (SD) pre- and post-decompression volumes were 9.50 (7.74) and 4.65 (4.34)?cm³, respectively (P?<?0.001), with a mean (SD) reduction of 49.86 % (19.34 %). The volume reduction was positively correlated with the duration of decompression (P?<?0.001), whereas no correlations with other variables were found (P?=?0.2357). The median monthly reduction in cyst volume was 11.34 % (mean, 13.52 %; range, 4.45–30.43 %) (P?<?0.001).

Conclusions

This three-dimensional CT investigation demonstrated the effectiveness of decompression in the treatment of mandibular odontogenic cystic lesions and showed a positive correlation between the duration of treatment and volume reduction.

Clinical relevance

Decompression treatment, which is simple to perform and generally well-accepted by patients, is a reliable method to considerably reduce the volume of mandibular odontogenic cystic lesions before surgical removal. Extended decompression time seems to improve results of the reduction process.