摘要： 目的：探讨颌骨囊性病变累及牙的牙髓存留对疾病预后的影响，为临床精准微创治疗颌骨囊性病变提供依据。方法：根据临床及影像资料，分析颌骨囊性病变累及牙的数量和程度，观察不同病理性质的颌骨囊性病变累及牙的牙髓活力；经不同手术方式治疗后，观察不同病理性质的颌骨囊性病变及其累及牙的预后。结果：经应用发现锥形束CT（CBCT）比常规X线片能更精确区分颌骨囊性病变累及牙的数量及程度。含牙囊肿、角化囊肿及单囊型成釉细胞瘤涉及的牙齿通常牙髓仍具有活力，根尖囊肿的病灶牙不具有牙髓活力，但累及牙常具有活力。开窗减压术后，部分受累及根尖可以被再生骨组织重新包绕，其牙髓仍保持活力。结论：囊肿累及牙的根尖未暴露于囊腔内，且其牙髓仍有活力，可以暂缓实施囊肿摘除术前的常规牙髓治疗。
关键词:
颌骨囊性病变,
牙髓活力,
治疗
Abstract: Objective: To explore the effect of pulp preservation on the prognosis of cystic lesions of jaw, and to provide evidence for the precise and minimally invisive treatment of cystic lesions of jaw. Methods: 1. According to clinical and imaging data, the number of teeth and degree of involvement in the cystic lesions was analyzed, and the pulp vitality of the teeth involved in all pathological types of jaw cystic lesions were observed; 2. Observed the prognosis of the cystic lesions and the affected teeth treated by different surgical methods. Results: 1) Cone beam computed tomography (CBCT) can accurately distinguish the number of involved teeth and degree of their involvement in cystic lesions of the jaw better than conventional radiographs. 2) The pulp of the teeth involved in dental cysts, keratocysts, and monocystic ameloblastoma are usually viable. Moreover, The pulp of the teeth that cause the radicular cysts are not viable, while the pulp of the teeth that involved in radicular cysts still remain vitality. 3) After decompression, a part of the affected root tip can be re-enclosed by the regenerated bone, and the pulp remains viable. Conclusion: If the apical end of the tooth is not in the cyst, and it’s pulp remains viable, the routine endodontic treatment before cystectomy can be suspended.
Key words:
Cystic Lesions of the jaw,
pup vitality,
treatment
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