Wang Jingwen, Jin Chunxiao, Zhao Yi, Huang Cui
State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China.
Department of Prosthodontics, School and Hospital of Stomatology, Wuhan University, #237 Luoyu Road, Hongshan District, Wuhan, Hubei, PR China.
BMC Oral Health. 2025 Feb 10;25(1):217. doi: 10.1186/s12903-025-05562-w.
To assess changes and factors influencing in buccolingual width and cyst cavity depth at the stoma site during marsupialization with cyst plug decompression for jaw cystic lesions.
Data were collected from patients who underwent marsupialization and cyst plug decompression for mandibular cystic lesions. A total of 15 cases were analyzed, including 10 odontogenic keratocysts (OKC), 1 unicystic ameloblastoma (UA), and 4 dentigerous cysts (DC). Cone beam computed tomography (CBCT) scans were conducted pre-surgery (T), three months post-surgery (T) and at the end of marsupialization (T, > 2 months post-T). Three-dimensional models were created to analyze bone dimensional changes in buccolingual width, vertical depth, and cyst volume.
The Friedman two-way rank analysis and subsequent pairwise comparisons demonstrated the cyst volume significantly decreased from T to T, T to T, respectively (p < 0.05). The buccolingual width remained basically unchanged from T to T (p = 0.423), but gradually decreasing from T to T (p < 0.001). Meanwhile, the cyst cavity depth consistently decreased throughout the study (p < 0.05). The Spearman rank correlation coefficient test indicated the final change in buccolingual width positively correlated with the initial width of the stoma site (p < 0.001).
Buccolingual width remains stable before decreasing, whereas cyst cavity depth and cyst volume decreases continuously. The larger the initial width of the stoma site, the greater change in width at the end of marsupialization.
During marsupialization, cyst plug modifications should align with bone remodeling patterns in jaw cystic lesions. Initially, only the plug's depth is adjusted, while in later stages, both stoma width and depth are gradually reduced. This understanding can contribute to the digital prefabricated series of cyst plugs by integrating clinical insights to develop more minimally invasive treatment strategies and to appropriately lengthen the decompression period during marsupialization.
评估颌骨囊性病变行袋形术联合囊肿塞减压时，造口部位颊舌径宽度和囊肿腔深度的变化及影响因素。
收集行袋形术联合囊肿塞减压治疗下颌囊性病变患者的数据。共分析15例病例，包括10例牙源性角化囊肿（OKC）、1例单囊型成釉细胞瘤（UA）和4例含牙囊肿（DC）。在术前（T0）、术后3个月（T1）和袋形术结束时（T2，T1后>2个月）进行锥形束计算机断层扫描（CBCT）。创建三维模型以分析颊舌径宽度、垂直深度和囊肿体积的骨尺寸变化。
Friedman双向秩分析及随后的两两比较显示，囊肿体积分别从T0到T1、T0到T2显著减小（p<0.05）。颊舌径宽度从T0到T1基本保持不变（p=0.423），但从T1到T2逐渐减小（p<0.001）。同时，在整个研究过程中囊肿腔深度持续减小（p<0.05）。Spearman秩相关系数检验表明，颊舌径宽度的最终变化与造口部位的初始宽度呈正相关（p<0.001）。
颊舌径宽度在减小之前保持稳定，而囊肿腔深度和囊肿体积持续减小。造口部位的初始宽度越大，袋形术结束时宽度的变化越大。
在袋形术期间，囊肿塞的调整应与颌骨囊性病变的骨重塑模式一致。最初，仅调整塞子的深度，而在后期，造口宽度和深度均逐渐减小。通过整合临床见解，这种认识有助于数字化预制系列囊肿塞，以制定更微创的治疗策略，并在袋形术期间适当延长减压期。
