Wagdargi Shivaraj S, Rai Kirthi Kumar, Arunkumar K V, Katkol Basavraj, Arakeri Gururaj
Reader, Department of Oral and Maxillofacial Surgery, Navodaya Dental College & Hospital, Raichur, Karnataka, India, Phone: +918792462013, e-mail:
Department of Oral and Maxillofacial Surgery, Bapuji Dental College & Hospital, Davangere, Karnataka, India.
J Contemp Dent Pract. 2016 Jun 1;17(6):489-95. doi: 10.5005/jp-journals-10024-1878.
Spontaneous regeneration of bone is commonly seen in the small surgical defects caused by enucleation of cysts. However, in case of large surgical defects caused by the enucleation, spontaneous regeneration of bone is a rare phenomenon and it depends on factors, such as age of the patient, intact periosteum, and proper stabilization.
The study included 16 patients, who reported to the department of oral and maxillofacial surgery with the complaint of pain and swelling in the jaws diagnosed as cyst. The sample included equal numbers of male and female subjects aged between 15 and 40 years. Panoramic radiographs were taken pre- and postoperatively on day 2 of the enucleation. The dimensions of the cyst were evaluated on the radiograph according to the proforma. Subsequent radiographs were taken at regular intervals of 1.5, 3, and 6 months using standard parameters and were analyzed using MCID™ analysis software of imaging research.
Mean reduction was seen in up to 39 and 60% in the cystic cavity size and increase in the mean density up to 59 and 90.2% at 3 and 6 months intervals respectively.
Spontaneous bone regeneration was seen even after primary closure of the large cystic defect without the need for placement of foreign substances or grafts and it also eliminated the complications resulting from placement of foreign substance. Further studies are required in a larger sample with longer follow-up durations to confirm the outcome of the present work for the benefit of patients.
The present study depicted that spontaneous bone regeneration can occur with accepted results after simple enucleation of jaw cyst without the aid of any graft material. Hence, simple enucleation may be considered as a first line of treatment modality for cystic lesion of the jaws. This simplifies the surgical procedure, decreases the economic and biologic costs, and reduces the risk of postoperative complications. Follow-up is necessary along with patient's compliance for the success of treatment.
骨的自发再生常见于囊肿摘除术造成的小手术缺损。然而，在囊肿摘除术造成的大手术缺损情况下，骨的自发再生是一种罕见现象，它取决于患者年龄、骨膜完整情况和适当固定等因素。
该研究纳入了16例因颌部疼痛和肿胀前来口腔颌面外科就诊且被诊断为囊肿的患者。样本中男女受试者数量相等，年龄在15至40岁之间。在囊肿摘除术后第2天拍摄术前和术后全景X线片。根据表格在X线片上评估囊肿大小。随后每隔1.5、3和6个月使用标准参数拍摄后续X线片，并使用成像研究的MCID™分析软件进行分析。
分别在3个月和6个月时，囊肿腔大小平均缩小达39%和60%，平均密度分别增加达59%和90.2%。
即使在大的囊性缺损一期缝合后，也能看到骨的自发再生，无需放置异物或移植物，且消除了放置异物导致的并发症。需要在更大样本、更长随访期的进一步研究中确认本研究结果，以造福患者。
本研究表明，在不借助任何移植材料的情况下，简单摘除颌骨囊肿后可出现可接受的骨自发再生结果。因此，简单摘除术可被视为颌骨囊性病变的一线治疗方式。这简化了手术过程，降低了经济和生物学成本，并降低了术后并发症风险。为确保治疗成功，随访以及患者的依从性是必要的。
