Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Guangdong Engineering Research Center of Oral Restoration and Reconstruction & Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou Medical University, 195 Dongfengxi Road, Yuexiu District, Guangzhou, China.
Department of Endodontics, School and Hospital of Stomatology, Guangdong Engineering Research Center of Oral Restoration and Reconstruction & Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou Medical University, 195 Dongfengxi Road, Yuexiu District, Guangzhou, China.
BMC Oral Health. 2024 Oct 15;24(1):1222. doi: 10.1186/s12903-024-04968-2.
Dentigerous cysts (DCs) are among the most frequently odontogenic cysts in young and middle-aged individuals. Marsupialization and enucleation are the main treatment options in clinical practice. However, there are few reports on preserving molars severely involved by the cyst.
A 35-year-old male patient with a large odontogenic cyst that was successfully treated using a multidisciplinary approach. The patient's chief complaint was discomfort during mastication in the lower left molar region for a month. Clinical examination revealed that teeth 36 and 37 were intact without pain upon percussion, while tooth 38 was unerupted. The radiology examination illustrated a typical well-defined oval radiolucent lesion surrounding the crown of unerupted tooth 38, extending to the distal root of tooth 37. The treatment was divided into two parts: removal of the cyst and the impacted third molar, followed by filling with collagen bone particles; and preserving the tooth 37 via hemisection, root canal treatment and crown restoration. Pathological examination indicated a dentigerous cyst. After 18 months of treatment, the bone defect completely recovered and tooth 37 functioned well following the hemisection.
Hemisection effectively preserves the cyst-associated molars and maintains oral function. This article underscores the significance of collaboration among various departments in the treatment of odontogenic cysts, ultimately aiming to achieve minimally invasive and functional surgery.
含牙囊肿（DCs）是年轻和中年人群中最常见的牙源性囊肿之一。临床上主要的治疗选择是开窗术和切除术。然而，关于严重受囊肿影响的磨牙的保留，鲜有报道。
一位 35 岁男性患者，患有大型牙源性囊肿，采用多学科方法成功治疗。患者的主要诉求是左下磨牙区咀嚼时一个月来一直感到不适。临床检查显示 36 和 37 号牙完整，叩诊无疼痛，而 38 号牙未萌出。影像学检查显示典型的界限清晰的椭圆形透光病变，环绕未萌出的 38 号牙的牙冠，延伸至 37 号牙的远中根。治疗分为两部分：切除囊肿和阻生的第三磨牙，并用胶原骨颗粒填充；通过半切、根管治疗和牙冠修复保留 37 号牙。病理检查提示为含牙囊肿。治疗 18 个月后，骨缺损完全恢复，37 号牙半切后功能良好。
半切术有效地保留了与囊肿相关的磨牙，并保持了口腔功能。本文强调了多学科合作在牙源性囊肿治疗中的重要性，最终旨在实现微创和功能性手术。
