669例牙源性颌骨囊肿临床分析

The odontogenic jaw cysts :analysis of the clinical parameters of 669 cases

目的 :比较角化囊肿、根端囊肿、含牙囊肿等三型牙源性颌骨囊肿的临床特点。方法 :收集 2 0年间牙源性角化囊肿 (odontogenickeratocyst,OKC)、根端囊肿 (radicularcyst ,RC)及含牙囊肿 (dentigerouscyst ,DC)的临床资料 ,对其性别构成、年龄分布、发病部位及临床表现等进行比较研究。结果 :①三型颌骨囊肿的男女之比分别为 :OKC 1.6∶1,RC 1.4∶1,DC 4.1∶1(x2 检验 ,P <0 .0 0 5 )。②除DC未见于 70岁以上年龄段外 ,几乎各年龄段均见三型颌骨囊肿的发生 ,三型囊肿组间及组内的年龄分布均有显著性差异 (x2 检验 ,P <0 .0 0 5 )。OKC及RC 2 0～ 2 9岁年龄段患病人数最多 ,分别占各年龄段患病人数的 2 7%及 2 0 % ;DC 10～ 19岁年龄段患病人数最多 ,占各年龄段患病人数的 2 9%。③颌骨的任一部位均见三型颌骨囊肿的发生 ,但发生频率不同 ,三型颌骨囊肿组间及组内发病部位的分布有显著性差异 (x2 检验 ,P <0 .0 0 5 )。OKC以下颌磨牙区发生率最高 ( 5 5 % ) ,其次为下颌前磨牙区( 4 1% ) ;RC及DC则以上颌前牙区发生率最高 ,二者的发生率分别为 5 7%与 75 %。④OKC有 13 7例合并感染 ,感染率 3 9% ;RC 48例合并感染 ,感染率 2 4% ;DC 18例合并感染 ,感染率 16% ,三型间有显著性差异 (x2 检验 ,P <0 .0 0

Objective:To study the clinical features of the odontogenic jaw cysts (OJC).Method:The clinical data of odontogenic keratocyst (OKC), radicular cyst (RC), and dentigerous cyst (DC) were collected, and their gender composition, age distribution, localization, and clinical presentation were analyzed.Result:(1)The male∶female ratio of OKC was 1.6∶1, RC 1.4∶1, and DC 4.1∶1(chi-square test,P<0.005). (2) The incidence of OJC was seen in almost all age groups except that DC was not seen in 70+ years group. The age distribution had a significant difference among the three kinds of OJC or in each cyst group (chi-square test, P<0.005). The incidence rate of OKC or RC in the third decade was the highest among that of all age groups (OKC, 27%; RC, 20%); the incidence rate of DC in the second decade was the highest (29%). (3) The three kinds of OJC were seen in all areas of the jaw with a different frequency, and the involved locations had significant differences among the three kinds of OJC or in each cyst group (chi-square test, P<0.005).The frequency of mandible molar region involvement in OKC was the highest (55%), and that of mandibular premolar region involvement was the second highest (41%); the frequency of maxillary anterior region involvement in RC and DC was the highest (RC, 57%; DC, 75%). (4)137 cases of OKC, 48cases of RC , and 18 cases of DC combined with infection (infection rate: OKC, 39%; RC, 24%; DC, 16%)(chi-square test, P<0.005).Conclusion:(1) Male predilection appears in OJC. (2) The peak incidence of OKC or RC is the third decade, and that of DC is the second decade. (3) A different location of the jaw has a different susceptibility for OKC, RC, or DC. The predilection localization of OKC is mandibular molar-premolar region, and that of RC or DC is maxillary anterior region. (4) The symptom of infection is helpful for the differential diagnosis among OKC, RC and DC.