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治疗牙源性角化囊肿的各种外科干预措施:一例放射学病例报告

Various Surgical Interventions in Treating Odontogenic Keratocyst: A Radiological Case Report.

作者信息

Gelețu Gabriela Luminița, Burlacu Alexandru, Baciu Elena-Raluca, Diaconu-Popa Diana, Murariu Alice, Foia Liliana Georgeta, Ungureanu Loredana, Onică Neculai

机构信息

Department of Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy, "Grigore T. Popa", 700115 Iasi, Romania.

Department of Internal Medicine, Nephrology, Geriatrics, Faculty of Medicine, University of Medicine and Pharmacy, "Grigore T. Popa", 700115 Iasi, Romania.

出版信息

Healthcare (Basel). 2023 Feb 1;11(3):416. doi: 10.3390/healthcare11030416.

Abstract

The odontogenic keratocyst (OKC) is among the most aggressive odontogenic cysts because of its high recurrent rate. This study's objective was to describe a 7-year radiological and clinical follow-up of an OKC with two recurrences and a combination of surgical treatments. The cyst contents were drained at the biopsy to allow decompression, and then marsupialization (Partsch I) was carried out with good results. In the following two years, the endodontic and radiological evaluation of the neighboring teeth indicated endodontic avoidance. The remaining OKC enucleation (Partsch II) with chemical curettage and suture was performed two years after the first presentation, and the multifocal recurrences developed were also treated by enucleation and chemical curettage. At the last radiological follow-up, no recurrence was evident. Based on our experience, we concluded that patients diagnosed with a OKC should be radiologically evaluated at least once a year for at least 7 years, the endodontic diagnosis and treatment of neighboring teeth should be performed as early as possible, and the combination of surgical treatment and the long follow-up period is challenging.

摘要

牙源性角化囊肿(OKC)因其高复发率而成为最具侵袭性的牙源性囊肿之一。本研究的目的是描述一例发生两次复发且采用多种手术治疗方法的OKC的7年影像学和临床随访情况。活检时将囊肿内容物引流以实现减压,然后进行袋形术(帕茨I式),效果良好。在接下来的两年里,对邻牙的牙髓和影像学评估表明应避免进行牙髓治疗。首次就诊两年后,进行了剩余OKC的摘除术(帕茨II式)并结合化学刮治和缝合,对出现的多灶性复发也采用摘除术和化学刮治进行治疗。在最后一次影像学随访时,未见复发迹象。根据我们的经验,我们得出结论,诊断为OKC的患者应至少7年每年进行一次影像学评估,应尽早对邻牙进行牙髓诊断和治疗,手术治疗与长期随访相结合具有挑战性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a470/9914541/be55cab28ca1/healthcare-11-00416-g001.jpg

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