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。

Characteristics of the Bone Formation and Remodelling Following Marsupialization of Jaw Odontogenic Keratocysts

Objective： To report characteristics of the bone formation and remodelling following marsupialization of jaw odontogenic keratocysts. Methods： Sixty--five patients with odontogenic keratocysts of the jaws underwent marsupialization. Clinical and radiographic examinations were made at postoperative 3 and 6 months. Computed tomography was carried out when panoramic radiographs showed destruction of the cortical plates in the involved ar- eas. Preoperative and postoperative radiographs and CT scans were evaluated for the following parameters： the outline of the cyst, integrity of the mandibular canal and cortical bone, migration or eruption of the impacted tooth, and bone formation within the cyst site. Results： Significant bone regeneration （a ground glass appearance） and reconsti- tution of normal anatomical structures,such as the mandibular canal and cortical bone, were found in the affected site at postoperative 3 months. The panoramic radiographs showed a continuous increase in bone density of the cystic area, with being 46.07% increase at postoperative 3 months and 64.69% at 6 months compared with preoperative values. Conclusion： More bone regeneration was found at the first 3 months than that at the second 3 months following marsupialization of large mandibular keratocysts and slower bone formation demonstrated with bone remod elling at the second 3 months.