Allon Dror M, Allon Irit, Anavi Yakir, Kaplan Ilana, Chaushu Gavriel
Senior Surgeon, Department of Oral and Maxillofacial Surgery; Director, OMS Residency Program, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel.
Oral Pathologist, Department of Oral Pathology, The Maurice and Gabriella Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
J Oral Maxillofac Surg. 2015 Apr;73(4):649-54. doi: 10.1016/j.joms.2014.10.024. Epub 2014 Oct 31.
To evaluate the efficiency of decompression in treating odontogenic cystic lesions of the jaws in children.
All consecutive odontogenic cysts occurring in children and treated by decompression from 1994 to 2009 at 1 maxillofacial center were included in the present study. Clinical data included age, gender, jaw, histopathologic diagnosis, and decompression time. Radiologic data from panoramic radiographs before and after decompression included tooth involvement, locularity, location, involvement of adjacent vital anatomic structures, and cyst area.
Thirty-two odontogenic cystic lesions from 26 children (14 boys [53.8%] and 12 girls [46.2%]) treated with decompression were included. The average age at the time of presentation was 11.6 ± 3.3 years (range, 7 to 18 yr). The mandible was involved in 13 cases (40.6%) and the maxilla in 19 (59.4%). All cysts were unilocular at presentation. Twenty-seven cysts (84.4%) showed tooth involvement. The diagnoses consisted of dentigerous cysts (20 [62.5%]), keratocysts (9 [28.1%]), and radicular cysts (3 [9.4%]). The mean decompression period was 7.45 ± 2.6 months (2 to 14 months). The mean standard lesion area index changed from 12.7 ± 0.9 mm(2) (3.6 to 44 mm(2)) before compression to 2.3 ± 4.3 mm(2) (0 to 22.3 mm(2)) after decompression. The mean percentage of reduction (POR) was 82 ± 16% (49 to 100%). The POR was ranked as good in 22 lesions (69%), moderate in 9 lesions (28%), and poor in 1 lesion (3%). Surgery was performed for 15 lesions (47%).
Decompression results in good regeneration potential of the bone in the developing craniofacial skeleton of children. Children might benefit from a less invasive surgical protocol.
评估减压治疗儿童颌骨牙源性囊性病变的疗效。
本研究纳入了1994年至2009年在1个颌面中心接受减压治疗的所有连续性儿童牙源性囊肿。临床数据包括年龄、性别、颌骨、组织病理学诊断和减压时间。减压前后全景X线片的放射学数据包括牙齿受累情况、分房情况、位置、相邻重要解剖结构受累情况及囊肿面积。
纳入了26例接受减压治疗的儿童的32个牙源性囊性病变（14例男孩[53.8%]，12例女孩[46.2%]）。就诊时的平均年龄为11.6±3.3岁（范围7至18岁）。下颌骨受累13例（40.6%），上颌骨受累19例（59.4%）。所有囊肿初诊时均为单房。27个囊肿（84.4%）显示有牙齿受累。诊断包括含牙囊肿20例（62.5%）、角化囊肿9例（28.1%）和根端囊肿3例（9.4%）。平均减压期为7.45±2.6个月（2至14个月）。平均标准病变面积指数从减压前的12.7±0.9mm²（3.6至44mm²）降至减压后的2.3±4.3mm²（0至22.3mm²）。平均缩小百分比（POR）为82±16%（49至100%）。22个病变（69%）的POR为良好，9个病变（28%）为中等，1个病变（3%）为差。15个病变（47%）接受了手术。
减压可使儿童发育中的颅面骨骼中的骨具有良好的再生潜力。儿童可能受益于侵入性较小的手术方案。
