减压术治疗下颌骨大型牙源性角化囊肿的临床研究

Clinical study of large mandibular odontogenic keratocyst treated by decompression

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χ2检验,计算Fisher确切概率。结果: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,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。减压术后引流期维持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:减压术是治疗下颌骨大型牙源性角化囊肿的有效方法。

PURPOSE： To clinically evaluate the effect of decompression used for large mandibular odontogenic keratocyst. METHODS： 61 cases with large mandibular odontogenic keratocyst underwent decompression from October 1999 to October 2004. All the patients were followed up for 6 months to 5 years. Clinical, X-ray and pathological examinations were performed for evaluation of the results. The changes in size of cysts before and after decompression were measured on panoramic X-ray films; the clinical effect and the recurrence rate were evaluated. SAS 6.12 software package was used for Chi-square test and Fisher exact test. RESULTS： After decompression, the sizes of the cysts reduced gradually, bone regeneration was noticed on radiographs. The displaced inferior alveolar neurovascular bundles returned to its normal position. The reposition of shifted teeth or bud was noticed, too. During the follow up period, no recurrence was found. The decompression period lasted from 6 months to 23 months, with a median time of 14 months. For clinical effect evaluation, a 91.8% complete response rate was obtained. Additionally, the single unicystic keratocyst had a better result than the muftilocular keratocyst. However, different age groups showed no statistically significant difference in terms of efficiency. CONCLUSION： Decompression is a kind of ideal method for large mandibular odontogenie keratocyst.