39例颌骨骨结构不良临床分析

Osseous dysplasias of the jaws:review of 39 consecutive cases

目的:探讨颌骨骨结构不良的临床特征、影像特点、治疗方式等。方法:对2015年1月-2019年9月收治的39例颌骨骨结构不良患者的临床资料进行回顾性分析,包括年龄、性别、好发部位、临床表现形式、影像特点以及治疗方式等。结果:患者年龄15〜73岁,中位年龄38岁,男、女比1:2.9,好发年龄段为30〜40岁(19/39,48.7%),下颌第一、第二磨牙根尖区为好发部位(17/39,43.5%)。根尖周骨结构不良5例,局灶性31例,繁茂性3例。影像特点主要表现为根尖区团块状阻射影,周围有透射影包绕的混合影(31/39,79.4%)。治疗方式均采取病变刮除术,部分患者行受累牙根管治疗(17例)或拔除(7例)。术后随访6个月〜2年,无颌骨感染等并发症。结论:骨结构不良多见于中青年女性,下颌磨牙区局灶性病变常见,有临床症状或骨膨胀的病变适合手术刮除。

PURPOSE:A retrospective research was made to evaluate the clinical characteristics, imaging features, treatment results of patients with osseous dysplasia(OD) of the jaws. METHODS: Thirty-nine patients were enrolled. The age,gender, locations of involvement, clinical and imaging features, treatment methods and results were retrospectively ana-lyzed. RESULTS: The age of patients ranged from 15 to 73 years old, with a mean age of 38 years. The male to female ratio was 1∶2.9. The most involved age group was 30-40 years old(19 cases, 48.7%). Apical regions of the mandibular first and second molars(17 cases, 43.5%) were the most involved locations. According to the classification of WHO, the most common type was focal OD(31 cases), periapical and florid OD were 5 and 3 cases, respectively. The main type of image characteristics was focal mixed radiopaque-radiolucent lesions(31 cases, 79.4%). The treatment methods were curettage of the lesions, in which root canal therapy was performed in 17 cases, and tooth extraction was performed in 7 cases. The follow-up period was 6 months to 2 years without postoperative complications. CONCLUSIONS:Osseous dysplasia of the jaws often involved the mandibular molar regions in female patients in their mid-thirties. The most common type of imaging characteristics was focal OD. Surgical curettage is indicated when the lesions are associated with clinical symptoms or significant bone expansion.