袋形术对牙源性角化囊性瘤受累牙牙周骨组织重建的作用
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摘要
目的:探讨袋形术对牙源性角化囊性瘤受累牙牙周组织重建的作用。方法:选取2012-09—2014-09于我院因牙源性角化囊性瘤行袋形术患者50例共213个受累牙,通过锥形束CT测量囊腔中受累牙根尖新生骨质的厚度,曲面断层片测量牙源性角化囊性瘤的面积,并对受累牙牙周骨组织术后3、12、24个月的重建情况进行分析。结果:袋形术后受累牙根尖周骨质平均覆盖率(97. 47%)较术前(64. 82%)显著增加; 213个受累牙中196个牙根尖周已被新生的骨质全部覆盖;剩余17个未被新生的骨质完全覆盖的牙齿,其新生骨覆盖率较术前增加了41. 90%;术后根尖周骨质破坏面积缩小值与新生骨质增厚值均随着时间的推移逐渐下降,二者间存在正相关性(r=0. 913,P <0. 05)。结论:牙源性角化囊性瘤患者袋形术后,受累牙牙周骨组织逐渐增加并重建,并将牙根尖暴露区覆盖,病变面积的缩小值与牙根尖周新生骨质的增厚值呈正相关。
AIM: To study the effects of pouch surgery on periodontal tissue reconstruction of odontogenic keratocysts. METHODS: 50 patients with odontogenic keratocystoma treated with a pocket-shaped bag were included. Before surgery and 3,12 and 24 months after treatment the length of the exposed teeth in the cyst and the thickness of the new bone in the interdental area were measured by CBCT. The area of the odontogenic sacral cystic tumor was measured by pantomography,and the reconstruction of the periodontal bone tissue of the affected tooth was analyzed.RESULTS: Before and after treatment the average coverage of the roots was 64. 82% and 97. 47% respectively( P <0. 05),the average coverage of the periapical area of the involved teeth was 39. 42% and 81. 32% respectively( P <0. 05). Among the 213 affected teeth,196 teeth were covered by the new bone and 17 were without new bone. The reduction of the lesion area and the increase of the thickness of the new bone around the root tip decreased gradually after each review( r = 0. 913,P < 0. 05). CONCLUSION: Pocket surgery may promote new bone formation after removal of odontogenic keratocystoma. The reduction of the lesion area is positively correlated with the increased periapical new bone thickness.
AIM: To study the effects of pouch surgery on periodontal tissue reconstruction of odontogenic keratocysts. METHODS: 50 patients with odontogenic keratocystoma treated with a pocket-shaped bag were included. Before surgery and 3,12 and 24 months after treatment the length of the exposed teeth in the cyst and the thickness of the new bone in the interdental area were measured by CBCT. The area of the odontogenic sacral cystic tumor was measured by pantomography,and the reconstruction of the periodontal bone tissue of the affected tooth was analyzed.RESULTS: Before and after treatment the average coverage of the roots was 64. 82% and 97. 47% respectively( P <0. 05),the average coverage of the periapical area of the involved teeth was 39. 42% and 81. 32% respectively( P <0. 05). Among the 213 affected teeth,196 teeth were covered by the new bone and 17 were without new bone. The reduction of the lesion area and the increase of the thickness of the new bone around the root tip decreased gradually after each review( r = 0. 913,P < 0. 05). CONCLUSION: Pocket surgery may promote new bone formation after removal of odontogenic keratocystoma. The reduction of the lesion area is positively correlated with the increased periapical new bone thickness.
引文
[1]白明茹.牙源性角化囊性瘤的研究进展[J].临床口腔医学杂志,2015,31(5):316-317.
[2]刘川,周宏志,侯锐,等.下颌骨大型牙源性角化囊性瘤口内摘除开放愈合的临床观察[J].华西口腔医学杂志,2014,32(6):566-569.
[3]王婧,武和明,王丽珍,等.牙源性角化囊性瘤开窗减压术后组织形态学改变[J].口腔生物医学,2013,4(1):40-43.
[4]张力,唐君玲,兰玉燕,等.袋形术对牙源性角化囊性瘤受累牙牙周骨组织重建的作用[J].广东医学,2016,37(9):1341-1344.
[5]张永宽,王兴强,王维玺,等.开窗减压联合二期刮治术治疗下颌骨大型牙源性角化囊性瘤的临床观察[J].中国美容医学,2015,24(13):38-40.
[6]伍栋,鲍光辉. 53例角化囊性瘤治疗方法的探讨[J].临床口腔医学杂志,2015,14(4):223-224.
[7]尹颂豪,张胜,钟汉铭,等. 50例下颌骨牙源性角化囊性瘤的手术疗效评价[J].中外医学研究,2014,12(33):136-137.
[8] Shudou H,Sasaki M,Yamashiro T,et al.Marsupialisation for keratocystic odontogenic tumours in the mandible:longitudinal image analysis of tumour size using 3D visualised CT scans[J]. Int J Oral Maxillofac Surg,2012,41(3):290-296.
[9]吴韫慧.袋形术对牙源性角化囊性瘤受累牙牙周骨组织重建的作用[J].口腔医学研究,2016,37(6):631-634.
[10]王超,马旭亮,蔡现良,等.负压吸引术在大型下颌骨牙源性角化囊性瘤治疗中的作用[J].国际口腔医学杂志,2015,42(5):545-547.
[11]王铁生,邓四海,黄仁财,等.囊肿减压成形术治疗大范围牙源性角化囊性瘤的效果分析[J].中国美容医学,2016,25(6):55-56.
[13]廖亚洲,刘冰,赵怡芳,等.牙源性角化囊性瘤患区牙保存的临床评估[J].武汉大学学报(医学版),2013,34(3):411-414.
[14]曾剑友,邹宏艺,杨红,等. 55例牙源性颌骨囊肿治疗体会[J].临床口腔医学杂志,2013,29(6):363-364.
[15]万志群.颌骨囊肿袋形术治疗牙源性颌骨囊肿35例[J].长江大学学报(自科版),2015,12(36):47-48.
[16]林敏校,姚小武,杨利和,等.开窗减压术联合刮治术治疗下颌骨大型牙源性角化囊性瘤[J].广东牙病防治,2012,20(9):488-491.
[17] Telles DC,Castro WH,Gomez RS,et al.Morphometric evaluation of keratocystic odontogenic tumor before and after marsupialization[J]. Braz Oral Res,2013,27(6):496-502.
[2]刘川,周宏志,侯锐,等.下颌骨大型牙源性角化囊性瘤口内摘除开放愈合的临床观察[J].华西口腔医学杂志,2014,32(6):566-569.
[3]王婧,武和明,王丽珍,等.牙源性角化囊性瘤开窗减压术后组织形态学改变[J].口腔生物医学,2013,4(1):40-43.
[4]张力,唐君玲,兰玉燕,等.袋形术对牙源性角化囊性瘤受累牙牙周骨组织重建的作用[J].广东医学,2016,37(9):1341-1344.
[5]张永宽,王兴强,王维玺,等.开窗减压联合二期刮治术治疗下颌骨大型牙源性角化囊性瘤的临床观察[J].中国美容医学,2015,24(13):38-40.
[6]伍栋,鲍光辉. 53例角化囊性瘤治疗方法的探讨[J].临床口腔医学杂志,2015,14(4):223-224.
[7]尹颂豪,张胜,钟汉铭,等. 50例下颌骨牙源性角化囊性瘤的手术疗效评价[J].中外医学研究,2014,12(33):136-137.
[8] Shudou H,Sasaki M,Yamashiro T,et al.Marsupialisation for keratocystic odontogenic tumours in the mandible:longitudinal image analysis of tumour size using 3D visualised CT scans[J]. Int J Oral Maxillofac Surg,2012,41(3):290-296.
[9]吴韫慧.袋形术对牙源性角化囊性瘤受累牙牙周骨组织重建的作用[J].口腔医学研究,2016,37(6):631-634.
[10]王超,马旭亮,蔡现良,等.负压吸引术在大型下颌骨牙源性角化囊性瘤治疗中的作用[J].国际口腔医学杂志,2015,42(5):545-547.
[11]王铁生,邓四海,黄仁财,等.囊肿减压成形术治疗大范围牙源性角化囊性瘤的效果分析[J].中国美容医学,2016,25(6):55-56.
[13]廖亚洲,刘冰,赵怡芳,等.牙源性角化囊性瘤患区牙保存的临床评估[J].武汉大学学报(医学版),2013,34(3):411-414.
[14]曾剑友,邹宏艺,杨红,等. 55例牙源性颌骨囊肿治疗体会[J].临床口腔医学杂志,2013,29(6):363-364.
[15]万志群.颌骨囊肿袋形术治疗牙源性颌骨囊肿35例[J].长江大学学报(自科版),2015,12(36):47-48.
[16]林敏校,姚小武,杨利和,等.开窗减压术联合刮治术治疗下颌骨大型牙源性角化囊性瘤[J].广东牙病防治,2012,20(9):488-491.
[17] Telles DC,Castro WH,Gomez RS,et al.Morphometric evaluation of keratocystic odontogenic tumor before and after marsupialization[J]. Braz Oral Res,2013,27(6):496-502.