双侧下颌第二磨牙阻生伴牙旁囊肿1例报告并文献复习

Bilateral mandibular second molar impaction with paradental cyst:A case report and literature review

目的:探讨1例双侧下颌第二磨牙阻生伴牙旁囊肿的病因及治疗,为其诊治提供参考。方法:患者囊肿累及左下颌第一磨牙,术前行根管治疗,局麻下拔除左下颌第二磨牙,刮匙刮除病变区残余牙囊、肉芽组织及囊肿壁,球钻打磨创腔及尖锐骨创缘,并磨除左下颌第一磨牙远中部分根尖,术中取组织行组织病理学检查。结果:X线片可见双侧下颌第二磨牙近中阻生,左下颌第二磨牙冠周有一边界清楚类圆形密度减低区,邻牙牙根吸收。术后病理回报示牙旁囊肿。结论:牙齿阻生伴牙旁囊肿可发生于除第三磨牙以外的其余牙位,其诊断需结合临床表现、病理和影像学检查,多学科会诊有利于其诊断和治疗。

Objective：To explore the etiology and treatment of one case of bilateral mandibular second molar impaction with paradental cyst,and to provide a reference for its diagnosis and treatment.Methods：Root canal treatment of the left mandibular first molar of the patient was performed before operation.The left mandibular second molar of the patient was removed;the residual dental follicle,the granulation tissue and the cyst wall were stroken off under local anesthesia.The diamond ball was used to polish the wound cavity and sharp bone edge,and to mill the distal apical part of left mandibular first molar.The tissue removed during the procedure was used for the pathological examination.Results：The X-ray image showed that the bilateral mandibular second molar was impacted with the left mandibular first molar root＇s absorption,and there was a clear round-like density reduction zone around the second molar crown.The pathologic result was paradental cyst.Conclusion：Dental impaction complicated with paradental cyst could occur in other tooth position except for the third molar.Its diagnosis should be combined with the clinical manifestations, the pathologic manifestations and the medical imaging.Multidisciplinary consultation is in favor of its diagnosis and treatment.