开窗减压术治疗替牙期下颌磨牙区含牙囊肿的临床研究

Clinical study of dentigerous cysts in mandibular molar region during mixed dentition treated by fenestration decompression

目的评价开窗减压术治疗替牙期下颌磨牙区含牙囊肿的临床疗效。方法选取2010年3月至2019年3月本院收治的20例8~12岁替牙期下颌磨牙区含牙囊肿患者,行开窗减压术,制作囊肿塞,每天行囊腔冲洗,术后1个月复查评估,每3个月复诊,行曲面断层片检查,观察囊肿长径、周围骨质变化及囊肿内恒牙胚萌出情况,纵向观察24个月,参照Nakamura的疗效评价标准评价治疗效果。结果术后1、3、6、12和24个月,囊肿长径进行性缩小,囊腔逐渐被新生骨代替,颌骨生长发育及牙胚未受影响。疗效评价术后1、3、6个月有效率差异具有统计学意义(P<0.05);术后12和24个月有效率差异无统计学意义。纵向观察24个月,18例(90.0%)含牙囊肿行开窗引流术疗效评价为优,1例(5.0%)评价为良,1例(5.0%)评价为疗效差,总有效率为95.0%。结论开窗引流术是治疗替牙期下颌磨牙区含牙囊肿的一种有效方法,能保留恒牙、避免损伤下牙槽神经。

Objective To evaluate the effect of fenestration decompression in the treatment of dentigerous cysts in mandibular molar region during mixed dentition.Methods 20 cases patients were treated in our hospital from March 2010 to March 2019,which fenestration decompression and clinically monitored every 3 months for 24 months after operation.Clinical symptoms and radiographical findings were analyzed according to Nakamura’s method.Results The cysts cavity had been gradually replaced by the new born bones.The growth of jaw and eruption of dental germ were uninfluenced.There was significant difference between 1,3 and 6 months after operation(P<0.05),and there was no significant difference between12 and 24 months.24 months after operation,the effect of fenestration decompression was evaluated as extremely effective(90.0%),moderately effective(5.0%),and poorly(5.0%).The total effective rate was 95.0%.Conclusion Fenestration decompression is an effective method for the treatment of dentigerous cysts in mandibular molar region during mixed dentition.It retains permanent teeth and avoids injuring inferior alveolar nerve.