下颌骨大型囊性病变开窗术后骨腔改变及其影响因素

目的:观察牙源性角化囊肿(odontogenic keratocyst,OKC),单囊型成釉细胞瘤(unicystic ameloblastoma,UAB)和根尖囊肿(radicular cyst,RC)开窗减压术后骨腔的改变,并分析其影响因素。方法:27例颌骨囊性病变患者中,OKC 16例,RC 6例,UAB 5例,均行开窗减压术,术后规律随访。运用Image J软件测量术前、术后口腔曲面体层片上病变区域骨密度和囊腔大小的变化,并进行分析。结果:OKC、UAB和RC开窗减压术后,骨腔逐渐缩小,骨密度逐渐增大。术后3个月,不同病理类型颌骨囊性病变开窗减压术后愈合速度不同,差异有统计学意义(P<0.05);术后6个月,3种类型囊性病变骨密度增加速度的差异无统计学意义(P>0.05)。骨腔大小变化与初始囊腔大小有一定的相关性(P<0.05)。骨密度变化与初始囊腔大小相关(P<0.05),不同病理类型囊性病变的骨密度增加速度不同,差异有统计学意义(P<0.05)。年龄与骨腔大小变化无相关性(P>0.05)。结论:开窗减压术治疗颌骨囊性病变效果显著,初始囊腔大小及病理类型对OKC、UAB和RC的愈合有一定的影响,年龄不影响开窗减压术后成骨速度。

Influencing Factors on Changes of Bone Cavity in Large Cystic Lesions of the Mandible after Marsupialization

Objective:To evaluate the dimension changes of bone cavity after decompression of odontogenic keratocyst(OKC),unicystic ameloblastoma(UAB)and radicular cysts(RC),and analyze the influencing factors.Methods:27 patients with large cystic lesions of jaw,including 16 cases of OKC,6 cases of RC and 5 cases of UAB who underwent decompression operation were followed up regularly.Image J software was used to measure and analyze the changes of bone mineral density and cyst size in the lesion area before and after surgery by oral panoramic radiography.Results:The size of bone cavity of OKC,UAB and RC decreased and the bone density increased gradually after decompression.The healing speed in different pathological types of cystic lesions was different in the first three months after decompression and had statistically significant(P<0.05).But,there was no statistically significant difference at six months postoperatively(P>0.05).The changes of bone mineral density were affected by initial cyst size(P<0.05).The increase rate of bone mineral density was statistically different among different pathological types of cystic lesions(P<0.05).There was no correlation between age and the change of bone cavity size(P>0.05).Conclusion:The marsupialization on the treatment of large cystic lesions of the jaw is effective.The initial cystic size and pathology of the lesions are among the influencing factors on the healing process.Age did not affect the rate of osteogenesis after decompression.