儿童下颌骨边缘性骨髓炎伴增生性骨膜炎X线调查

Radiographic investigation of periostitis ossificans of marginal osteomyelitis in the mandible of the children

目的 调查儿童下颌骨边缘性骨髓炎伴增生性骨膜炎X线特征、分型 ,并探讨有关病因。方法 X线及临床证实为下颌骨边缘性骨髓炎 2 0例儿童患者作为研究对象。由口腔放射专科医师读片分析 ,进行X线分型 ,记录结果。结果 分型分为I型和Ⅱ型 (增生型和溶解破坏型 ) ,I型 8例 ,其中I11例 ,I2 4例 ,I3 3例 ;Ⅱ型 12例 ,其中Ⅱ13例 ,Ⅱ2 5例 ,Ⅱ3 4例。部位多见于下颌骨升支、角部和乙状切迹 ,其中角部 +升支占 80 % ,最多见。发生原因主要是下颌第一恒磨牙、前磨牙、乳牙冠周及根尖感染 ;另一个主要因素是恒牙牙囊的感染 ,牙囊外骨皮质破坏。结论 ①下颌骨边缘性骨髓炎伴增生性骨膜炎的X线特征是骨板骨膜新骨形成 ;②骨膜新骨形成大多出现在角部或升支 ;

Objective The purpose is to study the radiographic features of periostitis ossificans with ossificans mandibular marginal osteomyelitis.To develop useful classification system,for this condition and causes. Methods 20 patients diagnosed marginal osteomyelitis were studied.To develop a useful classification system.The system was first divided into major categories according to whether the original contour of the mandible was preserved or lost.Each category was subdivided into there subtypes all radiographic observations were recorded.The radiographc were analyzed by oral radiologist. Results ①site That most common sites were listed in border of the mandible of the angle and ramous(80%).②cause Periapical ossificans was been exhibited of be associated with periodontal defect and perapical pathosis.Widening of the periodontal membrane was common in teeth believed to have incited the infection (10 cases).The cortex of the follicle of unerupted teeth was examined 20 patients exhibited destruction of part or all of one or more follicular cortices.The cause could not be determined in 2 patients.③type n=20 type I-8(I 1 1,I 2 4,I 3 3);type Ⅱ-12(Ⅱ 1 3,Ⅱ 2 5,Ⅱ 3 4). Conclusion ①The radiologic features of the form of osteomyelitis konwn as periostitis ossificans are laminar periosteal new bone.②The periosteal new bone is most often evident on the angle or ramus of the mandible.③Radiologic findings effacement of follicular are characteristic.This is a common sign ofinfection of jaw of children and may be failure of treatment oferadicate the disease.