颌骨假性囊肿：单中心回顾性研究 41 例。
Pseudocysts of the jaw: a retrospective study of 41 cases from a single institution.
机构信息
Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China.
出版信息
BMC Oral Health. 2023 Feb 11;23(1):87. doi: 10.1186/s12903-023-02741-5.
OBJECTIVE
The purpose of this retrospective study was to investigate and compare the clinical, radiographic, pathological, pathogenesis, and therapeutic features of simple bone cysts (SBCs) and aneurysmal bone cysts (ABCs) of the jaw.
METHODS
35 patients with SBCs and 6 patients with ABCs who received treatment at the Department of Oral and Maxillofacial Surgery, Zhejiang University School of Medicine from 2017 to 2022 were followed up and reviewed retrospectively.
RESULTS
The study included 41 patients, accounting for 2.14% of all jaw pathologies, with 35 patients having SBCs and 6 patients having ABCs; their average ages were 26.63 ± 13.62 years and 17.83 ± 7.88 years, respectively. The prevalence of SBC and ABC did not differ significantly by sex. The mandible was the most vulnerable area to be involved. Only 5.71% (2/35) of patients with SBCs and 16.7% (1/6) of patients with ABCs reported histories of previous trauma in the same region of the pseudocysts. A total of 42.86% (15/35) of SBC cases and 66.67% (4/6) of ABC cases had malocclusions. The radiographic features of pseudocysts varied in shape, were associated with the root, and unilocular or multilocular. All patients had curettage with or without bone graft or substitute implantation, and recurrences did not occur in 94.29% (33/35) of SBC patients and 100% (6/6) of ABC patients after a mean follow-up time of 26.23 ± 15.47 months and 21.67 ± 19.75 months, respectively.
CONCLUSIONS
Pseudocysts, including SBCs and ABCs, are benign osteolytic lesions without an epithelial lining that occur occasionally in the jaw, mostly in adolescents and young adults, and their incidence did not significantly differ by sex. The most vulnerable site of involvement is the mandible, and they are generally not overtly aggressive. Trauma has a less significant role in pseudocysts, but minor trauma, such as malocclusion, has the potential to influence pseudocyst development. The clinical presentation of pseudocysts lacks specificity, and most patients are asymptomatic and found incidentally during radiographs. Dental panoramic radiographs and CBCT cannot accurately distinguish between SBC and ABC, and the final diagnosis depends on pathological diagnosis. Curettage combined with bone grafting is currently the best treatment for both, with a 5.71% (2/35) recurrence rate for SBC and no recurrence found for ABC.
目的
本回顾性研究旨在调查和比较颌骨单纯性骨囊肿（SBC）和动脉瘤样骨囊肿（ABC）的临床、影像学、病理学、发病机制和治疗特征。
方法
2017 年至 2022 年，浙江大学医学院口腔颌面外科共收治 35 例 SBC 患者和 6 例 ABC 患者，对其进行回顾性随访和研究。
结果
本研究共纳入 41 例患者，占颌骨病变的 2.14%，其中 SBC 患者 35 例，ABC 患者 6 例；平均年龄分别为 26.63±13.62 岁和 17.83±7.88 岁。SBC 和 ABC 的患病率在性别上无显著差异。下颌骨是最易受累的部位。仅有 5.71%（2/35）的 SBC 患者和 16.7%（1/6）的 ABC 患者在同一假性囊肿区域有既往外伤史。42.86%（15/35）的 SBC 病例和 66.67%（4/6）的 ABC 病例存在错颌。假性囊肿的影像学特征呈不同形状，与根有关，为单房或多房。所有患者均行刮除术，联合或不联合植骨或替代物植入，SBC 患者中有 94.29%（33/35）和 ABC 患者中有 100%（6/6）在平均 26.23±15.47 个月和 21.67±19.75 个月的随访后无复发。
结论
假性囊肿，包括 SBC 和 ABC，是一种良性溶骨性病变，无上皮衬里，偶尔发生在颌骨，主要发生在青少年和年轻成人，且其发病率在性别上无显著差异。最易受累的部位是下颌骨，通常侵袭性不强。创伤在假性囊肿中作用较小，但轻微创伤，如错颌，可能影响假性囊肿的发展。假性囊肿的临床表现缺乏特异性，大多数患者无症状，在 X 线片检查时偶然发现。全景牙片和 CBCT 不能准确区分 SBC 和 ABC，最终诊断依赖于病理诊断。刮除术联合植骨是目前治疗这两种疾病的最佳方法，SBC 的复发率为 5.71%（2/35），ABC 无复发。
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