46例异位下颌第三磨牙及伴发病变的临床病例分析  

Clinical analysis of 46 cases of ectopic mandibular third molar and its associated disease

作　　者：宋悦 李中武 吴亚平 王东苗 周广超[1,3] 杨建荣 SONG Yue;LI Zhongwu;WU Yaping;WANG Dongmiao;ZHOU Guangchao;YANG Jianrong(Jiangsu Key Laboratory of Oral Disease;Department of Oral and Maxillofacial Surger;Department of Oral Radiology,Affiliated Hospital of Stomatology,Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]江苏省口腔疾病研究重点实验室,江苏南京210029 [2]南京医科大学附属口腔医院口腔颌面外科,江苏南京210029 [3]南京医科大学附属口腔医院口腔颌面影像科,江苏南京210029

出　　处：《口腔医学》2018年第11期995-998,共4页Stomatology

基　　金：江苏高校优势学科建设项目(2014-37);江苏省卫生计生委干部保健课题(BJ16031)

摘　　要：目的探讨总结异位下颌第三磨牙及其伴发病变的临床、影像学特点和治疗方法。方法收集自2012年1月—2017年12月就诊于南京医科大学附属口腔医院的下颌第三磨牙相关病例,经过全景片或CBCT诊断纳入异位下颌第三磨牙临床病例资料,分析其临床表现、影像学特点、伴发病变的病理表现以及治疗策略。结果共计46例(47颗)异位下颌第三磨牙符合纳入标准,主要好发于喙突、下颌支、下颌角及下颌骨体部。局部肿胀、疼痛及张口受限是其主要的临床症状,其中局部肿胀的发生与牙齿异位的解剖部位相关(P<0.05)。89.37%异位下颌第三磨牙常伴有牙源性囊肿或肿瘤。多数病例采用口内入路行牙拔除术同期去除伴随病变,术后并发症较少。结论异位下颌第三磨牙较为少见,临床诊断主要依赖于影像学,常伴有牙源性囊肿或肿瘤性病变,手术治疗总体预后良好。Objective To identify the clinical and radiographic characteristics as well as surgical removal method of ectopic mandibular third molar （EMTM） and its associated disease. Methods Clinical cases involving mandibular third molars treated from January 2012 to December 2017 in the Affiliated Stomatological Hospital, Nanjing Medical University were identified. All data regarding the ectopic mandibular third molars diagnosed by panoramic radiography or cone-beam CT were collected and analyzed to reveal the clinical manifestation, radiographic features, associated pathology and therapeutic strategy. Results A total number of 47 EMTMs in 46 patients meeting the inclusion criteria were included. They were frequently identified in coronoid, ramus, mandibular angle and body. Local swelling, pain and limited mouth opening were typical clinical symptoms. The occurrence of local swelling was associated with anatomic sites of ectopie teeth（P〈0.05）. 89.37% of EMTMs were accompanied with dentigerous cyst or tumor. Most cases were treated by intraoral approach to extract the EMTM and remove the simuhaneous disease, and there were fewer postoperative complications. Conclusions EMTM is a relatively rare disease entity and usually accompanied with odontogenic swelling or tumorous lesion. Its clinical diagnosis is mainly based on radiographic findings and the overall prognosis after operative treatment is favorable.

关 键 词：下颌第三磨牙 异位牙 锥形束CT 诊断 治疗 

分 类 号：R782.1[医药卫生—口腔医学]