中国实用口腔科杂志

中国实用口腔科杂志 ›› 2022, Vol. 15 ›› Issue (4): 440-443.DOI: 10.19538/j.kq.2022.04.012

• 论著 • 上一篇    下一篇

开窗减压术治疗恒牙列初期大型根尖周囊肿效果研究

康    鹏，乔永明，王　颖，何    巍，李    锐   

  1. 郑州大学第一附属医院口腔颌面外科，河南  郑州 450052
  • 出版日期:2022-07-30 发布日期:2022-08-31
  • 基金资助:
    国家自然科学基金（31670994）；河南省自然科学基金（182300410340）

  • Online:2022-07-30 Published:2022-08-31

摘要： 目的    探讨开窗减压术在恒牙列初期大型根尖周囊肿治疗中的效果。方法    选取2018年6月至2020年2月于郑州大学第一附属医院口腔颌面外科就诊的11例恒牙列初期大型根尖周囊肿患儿（11～13岁）临床资料进行回顾性分析。所有患儿均行开窗减压术，囊肿未完全消失的需行Ⅱ期刮治术。术后3、6、9、12、24个月定期随访，拍摄锥形束CT，测量囊肿面积、囊肿面积缩小率、囊肿面积缩小速度。结果    术后3、6、9个月囊肿面积依次为（8.34 ± 2.99）、（4.63 ± 2.01）、（1.79 ± 0.57）cm2，与术前囊肿面积（11.37 ± 1.76）cm2比较，差异均有统计学意义（t值依次为4.502、13.510、19.422，均P < 0.05）。术后3、6、9个月，囊肿面积缩小率依次为（27.28 ± 7.29）%、（59.27 ± 9.15）%、（84.23 ± 12.64）%，囊肿面积缩小速度依次为1.01、1.12、0.80 cm2/月。术后9个月，有1例囊肿完全消失，其余10例经10 ~ 12个月开窗减压治疗后行Ⅱ期刮治术。术后24个月，所有病例囊肿均完全消失，无复发。结论    开窗减压术是治疗恒牙列初期大型根尖周囊肿的有效手段，为Ⅱ期刮治术创造条件，甚至可使囊肿完全消失。

关键词: 恒牙列初期, 根尖周囊肿, 囊肿塞, 开窗减压术

Abstract: Objective    To investigate the effect of decompression in the treatment of large periapical cysts in the early permanent dentition. Methods    From June 2018 to February 2020，11 patients （11-13 years old） with large periapical cysts in the early permanent dentition were retrospectively analyzed. All patients underwent decompression. If the cyst did not disappear completely，stage Ⅱ curettage was required. At 3，6，9，12 and 24 months after operation，cone-beam CT was taken to measure the area of the capsule，the reduction rate and speed of the area of the capsule. Results     At 3，6 and 9 months after operation，the area of capsule cavity was（8.34 ± 2.99），（4.63 ± 2.01） and （1.79 ± 0.57）cm2，and the difference was statistically significant compared with that before operation  ［（11.37 ± 1.76）cm2 ］ （t values were 4.502，13.510 and 19.422，P < 0.05）. At 3，6 and 9 months after operation，the reduction rate of capsule area was（27.28 ± 7.29）%，（59.27 ± 9.15）% and （84.23 ± 12.64）%，and the speed was 1.01，1.12 and 0.80 cm2/month. At 9 months after surgery，the cystic cavity disappeared completely in one case，and the remaining 10 cases underwent stage Ⅱ curettage at 10-12 months after decompression. At 24 months after surgery，the cystic disappeared completely in all cases without recurrence. Conclusion    Decompression is an effective method in the treatment of large periapical cysts in the early permanent dentition，which creates conditions for stage Ⅱ curettage，and even promotes the complete disappearance of the cyst.  

Key words: early permanent dentition, radicular cyst, cyst plug, decompression