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下颌囊肿袋形术对改善相关骨缺损愈合的分析

Analysis of Marsupialization of Mandibular Cysts in Improving the Healing of Related Bone Defects.

作者信息

Consolo Ugo, Bellini Pierantonio, Melini Gian Marco, Ferri Agnese, Lizio Giuseppe

机构信息

Professor, Division of Maxillofacial Surgery, Department of Surgery, Medicine, Dentistry, and Morphological Sciences with Transplant Surgery, Oncology, and Regenerative Medicine Relevance, School of Dentistry, University of Modena and Reggio Emilia, Modena, Italy.

Researcher, Department of Surgery, Medicine, Dentistry, and Morphological Sciences with Transplant Surgery, Oncology, and Regenerative Medicine Relevance, School of Dentistry, University of Modena and Reggio Emilia, Modena, Italy.

出版信息

J Oral Maxillofac Surg. 2020 Aug;78(8):1355.e1-1355.e11. doi: 10.1016/j.joms.2020.02.034. Epub 2020 May 30.

Abstract

PURPOSE

Marsupialization, designed to reduce the mandibular cyst volume, has continued to debated regarding its influence on the healing of the related bone cavity. The aim of the present study was to evaluate the 3-dimensional radiographic variation over time in mandibular odontogenic cystic lesions after marsupialization and assess the correlations between these variations and variables that can affect the procedure.

MATERIALS AND METHODS

We planned a retrospective cohort study. The predictor variables were the treatment duration, preoperative volume, patient age, histologic type, and number of preoperative residual bony walls. The outcomes variables were the postoperative volume reduction and the daily reduction rate calculated using computed tomography (CT) from before to after marsupialization using software designed for volumetric reconstruction and measurement of cyst-related bone defects. The descriptive and bivariate statistics were computerized, and the significance level was set at P = .05.

RESULTS

The sample included 15 patients (12 men and 3 women; mean age, 51.6; range, 27 to 85 years) affected by keratocysts (n = 6), dentigerous cysts (n = 6), and radicular cysts (n = 3) who had undergone marsupialization. The median duration of marsupialization was 406 days (25th to 75th percentile, 276 to 519). The mean ± standard deviation (SD) pre- and postdecompression volumes were 6,908.27 ± 2,669.058 and 2,468.13 ± 1,343.517 mm, respectively (P < 0.001), and the mean ± SD percentage of reduction was 63.90 ± 13.12%. The volume decrease in the bone defects correlated positively with the treatment duration (P = .009) and preoperative volume (P < .001). However, no correlation was found with the other variables (P > .05) nor between the daily reduction rate and other variables (P > .05).

CONCLUSIONS

Marsupialization appears useful in improving the healing of cyst-related bone defects in mandibles, especially larger defects. Further studies with a wider sample size would add more knowledge to this topic.

摘要

目的

旨在减小下颌囊肿体积的袋形术,其对相关骨腔愈合的影响一直存在争议。本研究的目的是评估袋形术后下颌牙源性囊性病变随时间的三维影像学变化,并评估这些变化与可能影响该手术的变量之间的相关性。

材料与方法

我们计划进行一项回顾性队列研究。预测变量为治疗持续时间、术前体积、患者年龄、组织学类型和术前残余骨壁数量。结局变量为术后体积减小以及使用计算机断层扫描(CT)通过专门设计用于囊肿相关骨缺损体积重建和测量的软件计算出的袋形术前至术后的每日减小率。进行描述性和双变量统计分析,并将显著性水平设定为P = 0.05。

结果

样本包括15例接受袋形术的患者(12例男性和3例女性;平均年龄51.6岁;范围27至85岁),其中含角化囊肿(n = 6)、含牙囊肿(n = 6)和根尖囊肿(n = 3)。袋形术的中位持续时间为406天(第25至75百分位数,276至519天)。减压前后的平均±标准差(SD)体积分别为6,908.27±2,669.058和2,468.13±1,343.517mm³(P < 0.001),平均±SD减小百分比为63.90±13.12%。骨缺损体积的减小与治疗持续时间(P = 0.009)和术前体积(P < 0.001)呈正相关。然而,未发现与其他变量存在相关性(P > 0.05),且每日减小率与其他变量之间也无相关性(P > 0.05)。

结论

袋形术似乎有助于改善下颌骨囊肿相关骨缺损的愈合,尤其是较大的缺损。样本量更大的进一步研究将为该主题增添更多知识。

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