Clinical Evaluation and Application Analysis of Fenestration Decompression and Curettage for Jaw Cysts

doi:10.3969/j.issn.1005-4979.2018.04.008

Abstract

Abstract: Objective: To summarize and analyze the clinical effect of fenestration decompression and curettage for jaw cyst，and to research evidences for the choice of different treatments. Methods: In this study a total of 100 jaw cyst patients in department of maxillofacial surgery, Sichuan Provincial People's Hospital were chose. 50 cases treated with fenestration decompression were grouped as the observation group, and 50 cases with cyst curettage were the control group. Through the clinical follow-up over 2 years, the study compared clinical curative effects and post-operation complications between two groups. Analysis the advantages and indications for different operations. Results: When the jaw cysts were large(>3.0 cm×1.5 cm), the observation indicators including postoperative infection, neurological symptoms, pathological fracture, dental pulp vitality and bone healing period for observation group were significantly lower than the control group (P<0.05). When the jaw cysts were small(<3.0 cm×1.5 cm), the observation indicators including postoperative infection, neurological symptoms, pathological fractures were similar and with no statistical significance. But the bone healing periods were significantly shorter in the control group (P<0.05). Conclusions: The fenestration decompression as a minimaly invasive operation had very good clinical treatment effects and was very optimal for the patients whose jaw cysts were large. Further more, the reservation of living pulp was the greatest advantage of fenestration decompression operation. Relatively the faster new bone reconstruction could be acquired in the patients accepting curettage operation.

Key words: jaw cyst, fenestration decompression, curettage operation, cyst plug device.

摘要： 目的：通过对比颌骨囊肿开窗减压术与刮治术的临床疗效，分析颌骨囊肿的手术方式选择依据。方法：回顾分析四川省人民医院颌面外科100例颌骨囊肿手术病例。根据接受的术式，设定观察组及对照组，观察组采取囊肿开窗减压术，对照组采取囊肿刮治术，每组50例患者。通过2年以上的跟踪随访，对比两组患者的临床疗效及手术相关并发症，探讨两种术式优缺点及适应证。结果：囊肿范围>3.0 cm×1.5 cm时，患者平均住院日、术后感染率、受累牙牙髓活力、二期手术率等指标，观察组均明显优于对照组（P＜0.05）。囊肿范围<3.0 cm×1.5 cm时，两组的术后感染及病理性骨折等指标差异无统计学意义。不论囊肿大小，对照组骨质形成周期均明显缩短（P＜0.05）。结论：颌骨囊肿开窗减压术，适用于囊肿累及范围大、受累患牙数>3颗的病例，对依从性好的患者有极佳的疗效；开窗减压术具有保存患区牙髓活力的独特优势。

关键词: 颌骨囊肿, 开窗减压术, 刮治术, 囊肿塞治器

CLC Number:

R732.2

GUO Jun1, HUANG Yi1, FEI Wei1, CHEN Peng-yu1,2, WANG Yan-han1,3. Clinical Evaluation and Application Analysis of Fenestration Decompression and Curettage for Jaw Cysts[J]. 《Journal of Oral and Maxillofacial Surgery》, doi: 10.3969/j.issn.1005-4979.2018.04.008.

郭骏1，黄怡1，费伟1，陈鹏羽1，2，王砚寒1，3. 颌骨囊肿开窗减压术与刮治术临床疗效评价及应用分析[J]. 《口腔颌面外科杂志》, doi: 10.3969/j.issn.1005-4979.2018.04.008.

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URL: https://journal06.magtech.org.cn/Jweb_joms/EN/10.3969/j.issn.1005-4979.2018.04.008

https://journal06.magtech.org.cn/Jweb_joms/EN/Y2018/V28/I4/219

References

[1] Thoma KH. Oral surgery[J]. N Engl J Med, 1954, 250(14): 603-607.

[2] Wine WM, Welch JT, Graves RW. Marsupialization of a dentigerous cyst of the mandible: report of case[J]. J Oral Surg, 1971, 29(10):742-745.

[3] Pogrel MA. Treatment of keratocysts: the case for decompression and marsupialization[J]. J Oral Maxillofac Surg, 2005, 63(11):1667-1673.

[4] Cakarer S, Selvi F, Isler SC, et al. Decompression, enucleation, and implant placement in the management of a large dentigerous cyst[J]. J Craniofac Surg, 2011, 22(3): 922-924.

[5] 赵熠, 刘冰, 王贻宁. 囊肿塞在颌骨囊肿袋形术后引流中的应用[J]. 上海口腔医学, 2007, 16(6):592-594.

[6] 蒋自强, 赵怡芳. 负压吸引术治疗颌骨囊性病变[J]. 口腔颌面外科杂志, 2002, 12(1):13-15.

[7] Enislidis G, Fock N, Sulzbacher I,et al. [J]. Br J Oral Maxillofac Surg,2004,42(6):546-550.

[8] Anavi Y, Gal G, Miron H, et al. Decompression of odontogenic cystic lesions: clinical long-term study of 73 cases[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2011, 112(2):164-169.

[9] 高立明. 颌骨囊肿开窗减压术的临床观察[C].//2008'全国第十三届口腔医学学术研讨会论文集.盐城市中医院,2008:77-78

[10] 孙方方, 卢晓林, 聂蓉蓉, 等. 开窗减压配合囊肿塞治疗青少年颌骨囊肿的疗效分析[J]. 口腔医学, 2014, 34(5): 330-333.

[11] 吕凌峰. 开窗减压术在治疗颌骨囊肿中的应用及术后感染的预防[J]. 中国美容医学, 2013, 22(2):258-260.

[12] 樊明文.口腔医学新进展[M]. 2版. 武汉: 湖北科学技术出版社,2000:270．

[13] 胡振宇, 曹之强, 黄炜. 颌骨囊肿开窗术的临床效果评价[J]. 口腔颌面外科杂志, 2006, 16(2): 150-152.

[14] 宋碧连, 何慰思, 梁善钦, 等. 颌骨囊肿开窗减压术后受累牙牙髓活力变化的临床研究[J]. 临床医学工程, 2014, 21(6):711-712.

[15] Chacko R, Kumar S, Paul A, et al. Spontaneous bone regeneration after enucleation of large jaw cysts: A digital radiographic analysis of 44 consecutive cases[J]. J Clin Diagn Res, 2015, 9(9):ZC84-ZC89.

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