Alpy Alexandre, Tournaire Laurianne, Vaysse Fréderic, Marchal-Sixou Christine, Lhomme Arnaud, Courtois Bruno
Department of oral surgery, university of Toulouse, 31000 Toulouse, France.
Department of orthodontics, university of Toulouse, 31000 Toulouse, France.
Int Orthod. 2017 Jun;15(2):238-250. doi: 10.1016/j.ortho.2017.03.019. Epub 2017 Apr 29.
Keratocysts, also known as keratocystic odontogenic tumors (KCOT), make up 7% of all odontogenic cysts and develop asymptomatically in most cases. Enucleation is the benchmark treatment. However, there are surgical alternatives. Marsupialization and decompression are necessary in some cases, mainly when the KCOT is large, thus causing an increased risk of bone fracture, or if it has engulfed important elements such as the inferior alveolar nerve or teeth, consequently causing alveolar bone growth failure. The authors describe the case of a nine-year-old child treated for a large keratocyst situated in sector 4 (lower right jaw), impacting both premolars and the canine (45, 44 and 43). Surgical decompression associated with orthodontic multiband treatment were delivered to pull, and then place the three teeth in occlusion on the dental arch. With seven years hindsight since the first surgical procedure and three years since finishing orthodontic treatment, the cooperation between orthodontists and surgeons can be considered a success, from both the functional and esthetic points of view.
角化囊肿,也称为角化囊性牙源性肿瘤(KCOT),占所有牙源性囊肿的7%,大多数情况下无症状发展。摘除术是标准治疗方法。然而,还有其他手术选择。袋形缝合术和减压术在某些情况下是必要的,主要是当KCOT较大,从而导致骨折风险增加时,或者如果它包绕了重要结构,如下牙槽神经或牙齿,进而导致牙槽骨生长失败。作者描述了一名9岁儿童的病例,该儿童因位于4区(右下颌)的一个大型角化囊肿接受治疗,该囊肿影响了两颗前磨牙和一颗尖牙(45、44和43)。采用了与正畸多带环治疗相结合的手术减压方法来牵拉,然后将这三颗牙齿排列到牙弓上咬合。自首次手术过去7年,正畸治疗结束过去3年,从功能和美观的角度来看,正畸医生和外科医生之间的合作可被视为成功。