Zeevi Itai, Anavi Yakir, Kaplan Ilana, Zadik Yehuda
Department of Oral and Maxillofacial Surgery, Rabin Medical Center, Beilinson Campus, Petach Tikva, and Sackler Faculty of Medicine, Tel Aviv University, Israel.
J Oral Maxillofac Surg. 2013 Apr;71(4):694-701. doi: 10.1016/j.joms.2012.09.020. Epub 2012 Dec 21.
Our aims were to present 2 new cases of Gaucher disease involving the jaws and to review the literature.
Two new cases and the literature from 1982-2011 were reviewed.
Ten articles describing 35 cases (for a total of 37 with 2 new cases presented) were analyzed. The mandible and maxilla were affected in 97.3% and 24.3% of the reported cases, respectively. Generalized rarefaction of bone (osteopenia) was present in 83.8%, and well-defined radiolucent lesions in 40.5%. The effects on the surrounding structures included loss of cortication of the mandibular canal (56.7%), cortical bone thinning (27%), expansion, root resorption (24.3%), mandibular canal displacement (18.9%), cortical perforation, maxillary sinus obliteration, and tooth displacement (10.8%).
Two distinct bone abnormalities with separate pathophysiologies, radiographic presentation, and effects on the surrounding structures are suggested: 1) generalized mandibular/maxillary osteopenia and 2) a well-defined radiolucent lesion, which appears only in the mandible. This review refutes 2 accepted assumptions; according to the results, 1) the most common manifestation is generalized osteopenia (and the resulting mandibular canal changes), whereas the well-defined radiolucent lesion is the next most common, and 2) cortical bone thinning/perforations and lamina dura thinning are not uncommon in these patients.
我们的目的是介绍2例累及颌骨的戈谢病新病例并复习相关文献。
回顾了2例新病例以及1982年至2011年的文献。
分析了10篇描述35例病例的文章(加上本文报告的2例新病例,共37例)。在报告的病例中,下颌骨和上颌骨受累的比例分别为97.3%和24.3%。83.8%的病例存在全身性骨质稀疏(骨质减少),40.5%的病例存在边界清晰的透射性病变。对周围结构的影响包括下颌管皮质丧失(56.7%)、皮质骨变薄(27%)、膨胀、牙根吸收(24.3%)、下颌管移位(18.9%)、皮质穿孔、上颌窦闭塞和牙齿移位(10.8%)。
提示存在两种具有不同病理生理、影像学表现及对周围结构影响的明显骨异常:1)全身性下颌骨/上颌骨骨质稀疏;2)仅出现在下颌骨的边界清晰的透射性病变。本综述反驳了两个公认的假设;根据结果,1)最常见的表现是全身性骨质稀疏(以及由此导致的下颌管改变),而边界清晰的透射性病变是第二常见的;2)皮质骨变薄/穿孔和硬骨板变薄在这些患者中并不少见。