Lee Dong-Min, Ryu Jihye, Kim Hyeonjin, Lee Jae-Yeol
Department of Oral and Maxillofacial Surgery, Pusan National University Dental Hospital, Yangsan, Korea.
Department of Oral and Maxillofacial Surgery, Dental and Life Science Institute & Dental Research Institute, School of Dentistry, Pusan National University, Yangsan, Korea.
J Korean Assoc Oral Maxillofac Surg. 2024 Jun 30;50(3):153-160. doi: 10.5125/jkaoms.2024.50.3.153.
This study identifies factors for differential diagnosis among lesions by retrospectively comparing panoramic and cone-beam computed tomography images and analyzing the characteristics of lesions associated with impacted mandibular third molars (IMTs).
A retrospective cohort study was conducted in patients who simultaneously underwent IMT extraction surgery and related benign tumor resection or cyst enucleation at our institution from 2017 to 2021. To compare the characteristics of each group, two comparative analyses were conducted. The first comparison considered the most frequently observed lesions associated with IMTs: dentigerous cysts, odontogenic keratocysts (OKCs), and ameloblastoma. The second comparison involved placing dentigerous cysts, which have a relatively low recurrence rate, into group A and placing OKC, ameloblastoma, and odontogenic myxoma, which have high recurrence rates, into group B.
Significant differences in the size of the lesion were found in the order of ameloblastoma, OKC, and dentigerous cyst ( <0.05). The buccolingual width of ameloblastoma differed significantly from that of the other groups, with no significant difference observed between the OKCs and dentigerous cysts (=0.083).
Patient age and lesion size differed significantly among lesion types associated with IMTs, with younger age and larger lesions for OKCs and odontogenic tumors. OKCs are likely to have a larger mesiodistal width than dentigerous cysts. The buccolingual width of ameloblastomas was larger than those of dentigerous cysts and OKCs.
本研究通过回顾性比较全景片和锥形束计算机断层扫描图像,并分析与下颌阻生第三磨牙(IMT)相关病变的特征,确定病变鉴别诊断的因素。
对2017年至2021年在我院同时接受IMT拔除手术及相关良性肿瘤切除或囊肿摘除术的患者进行回顾性队列研究。为比较每组的特征,进行了两项对比分析。第一次比较考虑了与IMT最常观察到的病变:含牙囊肿、牙源性角化囊肿(OKC)和成釉细胞瘤。第二次比较是将复发率相对较低的含牙囊肿归入A组,将复发率高的OKC、成釉细胞瘤和牙源性黏液瘤归入B组。
发现病变大小按成釉细胞瘤、OKC和含牙囊肿的顺序存在显著差异(<0.05)。成釉细胞瘤的颊舌宽度与其他组有显著差异,OKC和含牙囊肿之间未观察到显著差异(=0.083)。
与IMT相关的病变类型中,患者年龄和病变大小存在显著差异,OKC和牙源性肿瘤患者年龄较小且病变较大。OKC的近远中宽度可能比含牙囊肿大。成釉细胞瘤的颊舌宽度大于含牙囊肿和OKC。