Liang Y-j, He W-j, Zheng P-b, Liao G-q
Guangdong Provincial Key Laboratory of Stomatology, Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China.
Department of Stomatology, Longgang District People's Hospital of Shenzhen, Shenzhen, Guangdong, China.
Oral Dis. 2015 Jul;21(5):674-8. doi: 10.1111/odi.12338. Epub 2015 Apr 6.
The treatment of large mandibular cystic lesions (diameter > 35 mm) is controversial. Few studies determine the inferior alveolar nerve function after decompression which is one of the major options for treating such lesions. We aim to investigate the recovery of inferior alveolar nerve function after decompression.
Twenty-two patients with large mandibular cystic lesions, diagnosed as keratocystic odontogenic tumor, ameloblastoma, or dentigerous cyst, were included. Inferior alveolar nerve function was observed by monitoring the pulp vitality of involved teeth (n = 64) with electric pulp test before decompression and 1, 3, 6, 9, 12, and 24 months after decompression, respectively.
The pulp vitality of the involved teeth was significantly decreased before decompression. Recovery of pulp vitality could be observed after decompression, indicating the recovery of inferior alveolar nerve function. A majority (96.9%) of the vital pulp was preserved in the involved teeth after decompression.
Recovery of inferior alveolar nerve function was remarkable in patients with large mandibular cystic lesions after decompression, indicated by the recovery of pulp vitality of involved teeth. When decompression is preferred, conservative therapy rather than root canal therapy is recommended for the teeth with root tip exposed in the cystic lesions and without pulposis.
大型下颌骨囊性病变(直径>35mm)的治疗存在争议。很少有研究确定减压后下牙槽神经功能,而减压是治疗此类病变的主要选择之一。我们旨在研究减压后下牙槽神经功能的恢复情况。
纳入22例大型下颌骨囊性病变患者,诊断为牙源性角化囊性瘤、成釉细胞瘤或含牙囊肿。分别在减压前以及减压后1、3、6、9、12和24个月,通过用电活力测试监测患牙(n = 64)的牙髓活力来观察下牙槽神经功能。
减压前患牙的牙髓活力显著降低。减压后可观察到牙髓活力恢复,表明下牙槽神经功能恢复。减压后大部分(96.9%)患牙的活髓得以保留。
大型下颌骨囊性病变患者减压后下牙槽神经功能恢复显著,表现为患牙牙髓活力恢复。当选择减压治疗时,对于根尖暴露于囊性病变且无牙髓病变的牙齿,建议采用保守治疗而非根管治疗。