Zhao Yi, Liu Bing, Zhao Yi Fang
Chin J Dent Res. 2019;22(2):81-92. doi: 10.3290/j.cjdr.a42512.
The continual growth of cystic lesions of the jaws can cause bone expansion, facial deformity, impacted teeth, occlusal disorder and displacement and loosening of the originating tooth or adjacent teeth. The management of teeth associated with cystic lesions of the jaws has been widely debated. When standing teeth with vital pulp are associated with cystic lesions, especially when tooth roots protrude into the cyst cavity, different treatment options have been recommended to support tooth preservation. However, there is no consensus about the extraction of the affected tooth in cases of root involvement by odontogenic keratocyst (OKC). In addition, there is controversy around whether root canal therapy should be considered a necessary treatment to be carried out prior to or after enucleation when standing teeth are associated with cystic lesions. An impacted tooth enclosed in the cavity of a developmental cyst may be treated by various approaches such as marsupialisation or decompression, or enucleation in combination with extraction or coronectomy, depending on the patient's age, root development and the angle and depth of the tooth in the jaw. Successful results obtained in pulp revascularisation after autotransplantation or endodontic regeneration treatments have been reported and pulp tissue functionality after cyst enucleation or apicetomy is a serious concern. In this article, we present an overview of the management of teeth associated with cystic lesions of the jaws.
颌骨囊性病变的持续生长可导致骨质膨胀、面部畸形、牙齿阻生、咬合紊乱以及患牙或邻牙移位和松动。与颌骨囊性病变相关牙齿的处理一直存在广泛争议。当活髓恒牙与囊性病变相关时，尤其是当牙根突入囊肿腔时，人们推荐了不同的治疗方案以支持保留牙齿。然而，对于牙源性角化囊肿（OKC）累及牙根时患牙的拔除，目前尚无共识。此外，当恒牙与囊性病变相关时，根管治疗应在摘除囊肿之前还是之后进行，这一点也存在争议。对于包裹在发育性囊肿腔内的阻生牙，可根据患者年龄、牙根发育情况以及牙齿在颌骨中的角度和深度，采用多种方法进行治疗，如袋形术或减压术，或摘除囊肿并联合拔牙或牙冠切除术。自体移植或牙髓再生治疗后牙髓血管再生取得成功的报道已有不少，而囊肿摘除或根尖切除术之后牙髓组织的功能是一个令人严重关切的问题。在本文中，我们将对与颌骨囊性病变相关牙齿的处理进行综述。
