开窗减压术与负压吸引术治疗颌骨大型牙源性囊性病变的对比研究  

Clinical study on decompression and suction drainage in the treatment of large jaw odontogenic cystic lesions

作　　者：余东升 赵玮 吴晓林[2] 俞娟[2] 

机构地区：[1]中山大学附属口腔医院口腔医学研究所,广州510055 [2]澳门仁伯爵医院口腔科

出　　处：《中华临床医师杂志（电子版）》2011年第14期4093-4099,共7页Chinese Journal of Clinicians(Electronic Edition)

基　　金：国家自然科学基金(30973340);广东省自然科学基金(9151008901000187);广东省科技计划项目(2008B03030113;2011B050400030)

摘　　要：目的观察开窗减压术和负压吸引术治疗颌骨大型牙源性囊性病变的疗效并进行比较分析,探讨保守性治疗在治疗颌骨大型牙源性囊性病变中的应用价值。方法选取24例直径大于3 cm的颌骨大型牙源性囊性病变,其中包括7例含牙囊肿、14例牙源性角化囊性瘤以及3例单囊性成釉细胞瘤,开窗后用弹性自凝材料制作个体化囊肿塞,随机分为2组,分别采用开窗减压术和负压吸引术进行治疗。对两组患者进行临床和影像学观察,通过测量囊腔体积改变及曲面断层片缺损范围比较囊性缺损缩小速度,对病变范围的缩小情况量化后进行统计学分析。结果 24例颌骨大型牙源性囊性病变经开窗减压术或负压吸引术均取得较好疗效,3~13个月后囊性病损缩小到直径1 cm左右时行二次手术刮除,随访6~28个月,未发现复发病例。负压吸引术组患者疗程3~8个月,平均5.4个月,开窗减压术患者疗程4~13个月,平均9.5个月,二者有统计学差异(P<0.05)。负压吸引术患者病变囊腔容积及影像面积减小速度均明显快于开窗减压术患者,且颌面部膨胀畸形改善快于开窗减压术组。结论开窗减压术和负压吸引术均能有效治疗颌骨大型牙源性囊性病变;负压吸引术较单纯开窗减压术可显著缩短疗程,且对恢复面部正常形态、消...Objective To observe the clinical treatment effects of decompression and suction drainage in the treatment of large jaw odontogenic cystic lesions.Methods 24 cases of large odontogenic cystic lesions of jaw were chosen in our study.There were 7 cases of dentigerous cyst(DC),14 cases of kerotocystic odonogenic tumor(KCOT) and 3 cases of unicystic ameloblastoma(UA).Prepared individual cyst plug using special permanently soft durable reline(Mucopren soft) after fenestration.Divided them into 2 groups according to the treatment either decompression only or decompression with negative pressure suction treatment.The progresses were observed by radiological examination through dental panoramic film and measurement of the changes of bone density and liquid volume inside the lesion.The degree of decreasing of the lesion was quantified and statistically analyzed.Results Total 24 cases of jaw large odontognenic lesions with the treatment of decompression or suction drainage had been reported to have pretty good result.In average,the second phase surgery was carried out after 3-13 months treatment,when the cystic lesion was less then 1 cm in diameter.Followed up for 3-28 months,no any finding of recurrence.The treatment period of suction drainage group was 3-8 months,average 5.4 months.The treatment period of fenestration was 4-13 months,average 9.5 months.There was markedly difference between suction drainage group and decompression group(P<0.05).In the suction drainage group,the rate of decrease in size of the involved cystic lesion was obviously faster compared with decompression group.In addition,the therapeutic effect on the facial bulging asymmetry deformity was also better.Conclusions Both decompression and suction drainage technique are effective in the treatment of large odontogenic cystic lesions.The treatment period of suction drainage is shorter than simple decompression,and it has a better result in recovering the facial deformity and establishing facial asymmetry.

关 键 词：牙源性囊肿 成釉细胞瘤 含牙囊肿 减压术 外科 抽吸 

分 类 号：R782[医药卫生—口腔医学]