开窗减压术联合囊肿塞治疗青少年大型下颌骨囊肿的临床研究

The clinical effect of fenestration decompression combined with cyst plug in treatment of juvenile with large mandible cyst

目的观察开窗减压术联合囊肿塞治疗青少年大型下颌骨囊肿的疗效。方法对21例青少年大型下颌骨囊肿患者行开窗减压联合囊肿塞治疗,术后随访1~4年,观察不同时期囊腔体积变化以及受累牙手术前后牙髓活力的变化情况。结果应用CBCT测量囊腔体积变化情况,术后囊腔体积明显缩小,以术后6个月内缩小速度最快;术后12月较术后6月囊腔体积虽然仍有缩小,但两个时间点囊腔体积无统计学差异。开窗减压术后,术后6月牙髓活力略降低,但与术前相比较,两者差异无统计学意义。结论青少年大型颌骨囊肿应积极应用开窗减压术治疗,效果显著,并且有利于囊腔波及牙齿的牙髓活力的保留。开窗后6月到12月期间要密切关注囊腔骨质新生情况,对于囊腔变化放缓的患者要分析原因及时跟进二期囊肿刮治术。

Objective To discuss the effect of fenestration decompression combined with cyst plug in treatment of juvenile large mandible cyst.Methods Twenty-one cases of juvenile patients with large mandible cyst were treated with fenestration decompression combined with cyst packing.The patients were followed up for 1~4 years.The changes of cyst volume in different periods and the changes of pulp vitality of affected teeth before and after operation were observed.Results CBCT was used to measure the change of the cystic cavity volume.The volume of the cystic cavity was significantly reduced after operation,and the fastest reduction rate was within 6 months after operation.Although the volume of the capsule cavity was still reduced at 12 months after operation compared with 6 months after operation,there was no statistical difference in the volume of the cavity between the two time points.After fenestration decompression,the pulp vitality decreased slightly 6 months after operation,but there was no significant difference between the two groups.Conclusion The results showed that the fenestration and decompression should be actively applied in the treatment of large jaw cysts in adolescents,which has a significant effect and is conducive to the preservation of pulp vitality of the teeth affected by the cyst cavity.During the period from 6 months to 12 months after fenestration,we should pay close attention to the new bone formation in the cystic cavity,and analyze the reasons for the slow change of cystic cavity,and timely follow up the second stage cyst curettage.