Kang Yei-Jin, Kim Min-Keun, Kim Seong-Gon, Park Young-Wook, Oh Ji-Hyeon
Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea.
J Korean Assoc Oral Maxillofac Surg. 2025 Feb 28;51(1):33-40. doi: 10.5125/jkaoms.2025.51.1.33.
Clinical situations that make it challenging to differentiate odontogenic cysts from non-odontogenic cysts and benign tumors of the jaw include cases with cystic conditions accompanied by secondary infection, impacted teeth, cortical thinning and expansion, or external root resorption. This study aimed to identify risk factors for complications in patients undergoing cyst enucleation of the jaw, propose a clinical model, and determine the necessary indications for preoperative root canal of adjacent teeth.
A review of surgical, pathological, and radiological reports, as well as medical records, was conducted. Pathological diagnosis, lesion size, history of preoperative endodontic treatment of the adjacent tooth, operator details, surgical procedures, age, gender, and complications (with severity) were analyzed.
This study involved 77 patients (55 men, 22 women) and found 10 complications. Procedure type (cyst enucleation only, apicoectomy and bone graft, or bone graft only) and lesion size were significant risk factors. Preoperative root canal therapy and men gender also tended to positively correlate with complications, while age was not a factor.
Within the limitations of our study, additional procedures contributed to lower risk of complications with the exception of bone graft. A large cyst size was also associated with a higher risk of complications. It is important to consider the possibility of a second procedure and take thorough precautions to prevent infection when performing bone grafts. Patients should be informed of these risks in advance, scheduled for regular follow-up, and provided additional treatment when necessary.
在临床情况中，区分牙源性囊肿与非牙源性囊肿以及颌骨良性肿瘤具有挑战性，这些情况包括伴有继发感染、阻生牙、皮质变薄和扩大或牙根外吸收的囊性病变。本研究旨在确定颌骨囊肿摘除术患者并发症的危险因素，提出一种临床模型，并确定相邻牙齿术前根管治疗的必要指征。
对手术、病理和放射学报告以及病历进行了回顾。分析了病理诊断、病变大小、相邻牙齿术前牙髓治疗史、操作人员详细信息、手术步骤、年龄、性别和并发症（及其严重程度）。
本研究纳入77例患者（55例男性，22例女性），发现10例并发症。手术类型（仅囊肿摘除术、根尖切除术和骨移植术或仅骨移植术）和病变大小是显著的危险因素。术前根管治疗和男性性别也往往与并发症呈正相关，而年龄不是一个因素。
在我们研究的局限性内，除骨移植外，额外的手术操作有助于降低并发症风险。囊肿较大也与较高的并发症风险相关。在进行骨移植时，考虑二次手术的可能性并采取全面的预防感染措施非常重要。应提前告知患者这些风险，安排定期随访，并在必要时提供额外治疗。
