减压术在根尖囊肿治疗中的应用进展

The State of Art of Decompression in Management of Radicular Cysts

根尖囊肿是常见的颌骨囊肿,目前常规的治疗方式首选根管治疗术。对于大型根尖囊肿,还需行囊肿刮除术。刮除术临床疗效好,但术中易损伤邻牙正常的牙髓活力及邻近重要的解剖结构。减压术/开窗术作为治疗大型颌骨囊肿的有效方法之一,具有微创并能减少并发症等优点。近年来减压术在根尖囊肿中的应用得到关注,并取得了较好的疗效。其具体机制可能包括降低囊腔压力,促进新骨形成;引流介导破骨反应的炎性因子白细胞介素-1(interleukin-1,IL-1)等,改变囊壁上皮细胞增殖生长的微环境;充分引流囊液以利根管干燥,提高根管充填的严密性。本文对减压术治疗根尖囊肿作一综述,为根尖囊肿综合治疗提供新的思路。

Radicular cysts are the common jaw cyst and are often treated by root canal treatment.For large radicular cysts,enucleation is necessary.Although enucleation can achieve satisfactory therapeutic effects,it increases the risks of damaging other vital structures and the roots of adjacent teeth.As an adjuvant treatment of large odontogenic cysts,marsupialization/decompression is less invasive and causes less complication,which has drawn attention from endodontists and had been successfully applied in recent years.Its mechanisms may include the release of intracysic pressure and enhancement of osteogenesis,drainage,and reduction of the IL-1 which mediates osteoclast formation,which therefore changes the microenvironment reducing division of epithelial cells.Decompression also facilitates drainage of the cystic exudate so that the root canal can be completely dried and sealed.The present paper aimed to review the developments of decompression as a supplementary procedure in the management of radicular cysts and conclude that decompression might be adopted as part of a comprehensive strategy for treatments of radicular cysts.