开窗减压术结合牵引矫治方法治疗替牙期含牙囊肿的疗效观察

Therapeutic effects of marsupialization and orthodontic traction on treatment of dentigerous cyst in mixed dentition stage

目的观察开窗减压术式结合牵引矫治方法治疗替牙期含牙囊肿的治疗效果。方法收集南京医科大学附属口腔医院2007-2012年收治的12例替牙期颌骨含牙囊肿病例,采取开窗减压手术治疗保留囊肿涉及的恒牙、佩戴塞制器保持引流口通畅并进行间隙保持,结合后期的固定矫治器正畸牵引治疗,术后随访2-3年观察颌骨内囊肿骨组织愈合及恒牙萌出情况。结果本组12例含牙囊肿患儿经开窗减压术结合牵引矫治方法治疗后12-15个月后,所有患儿囊肿包含的恒牙全部牵引出龈且经治疗后牙齿排列整齐,面部形态恢复正常,影像学检查显示囊腔低密度影消失,术后随访2年以上均未见囊肿复发。结论对儿童替牙期颌骨含牙囊肿采取开窗减压术结合正畸治疗是一种能够最大程度保留病变区恒牙及颌骨组织的有效方法。

Objective To observe the therapeutic effects of marsupialization and orthodontic traction on the treatment of dentigerous cyst in mixed dentition stage. Methods Twelve cases of dentigerous cysts in mixed dentition stage were treated at the Affiliated Hospital of Stomatology,Nanjing Medical University from 2007 to 2012 with marsupialization of the cysts to preserve permanent tooth buds,then obturators were used to guarantee the effective draining and maintain the teeth space,and further orthodontic treatment was carried out to ensure the normal eruption of the involved teeth. The patients were followed up for 2 - 3 years after marsupialization,and the bone tissue healing and permanent teeth eruption were observed. Results After the therapy of marsupialization and further treatment of orthodontic traction for 12 - 15 months,permanent teeth which were involved in the cysts of all the 12 patients erupted totally and dental arrangement was kept in alignment. Patients＇ facial morphology returned to normal,and the low-density shadow of cyst cavity disappeared according to imageological examination. No cyst recurrence was observed during the following up for more than 2 years postoperatively. Conclusions Marsupialization and further orthodontic treatment is an effective treatment of dentigerous cysts in mixed dentition stage,which could retain the involved teeth and bone tissue to the maximum degree.