CAJ | 학술논문

目的观察开窗减压术治疗儿童混合牙列期牙源性颌骨囊肿的疗效及最佳评价时点.方法 28例4～12岁的儿童颌骨囊肿病例,行囊肿上方乳牙拔除或颊侧翻瓣开窗术,同期冲洗引流管植入固定,每日行抗生素溶液囊腔冲洗.于术后1,3,6个月复诊,行曲面断层片观察对比疗效.参照Nakamura袋形术治疗颌骨囊肿的疗效评价标准对各时间点的治疗效果进行观察.结果术后1、3和6个月囊肿长径进行性缩小.Fisher's确切概率法疗效评价结果为,术后1和3个月有效率差异有统计学意义;而术后3个月和6个月有效率差异无统计学意义.术后3个月观察,19例(67.86%)颌骨囊肿行开窗减压术后疗效评价为优,8例(28.57%)评价为良,1例(3.57%)评价为疗效差,总有效率为96.43%,与1年后的最终治愈率相同.骨质破坏区面积有较大程度的缩小甚至基本消失,囊腔周围新骨生成活跃,挤压移位的恒牙胚基本回位并能正常萌出,患儿能够很好配合和耐受.结论儿童混合牙列期颌骨囊肿开窗减压术,很好地起到了导萌、保留恒牙、去除囊肿的效果,是一项适合推广的技术方法.术后3个月是疗效评价最佳时点.
목적 관찰개창감압술치료인동혼합아렬기아원성합골낭종적료효급최가평개시점.방법 28례4～12세적인동합골낭종병례,행낭종상방유아발제혹협측번판개창술,동기충세인류관식입고정,매일행항생소용액낭강충세.우술후1,3,6개월복진,행곡면단층편관찰대비료효.삼조Nakamura대형술치료합골낭종적료효평개표준대각시간점적치료효과진행관찰.결과 술후1、3화6개월낭종장경진행성축소.Fisher's학절개솔법료효평개결과위,술후1화3개월유효솔차이유통계학의의;이술후3개월화6개월유효솔차이무통계학의의.술후3개월관찰,19례(67.86%)합골낭종행개창감압술후료효평개위우,8례(28.57%)평개위량,1례(3.57%)평개위료효차,총유효솔위96.43%,여1년후적최종치유솔상동.골질파배구면적유교대정도적축소심지기본소실,낭강주위신골생성활약,제압이위적항아배기본회위병능정상맹출,환인능구흔호배합화내수.결론 인동혼합아렬기합골낭종개창감압술,흔호지기도료도맹、보류항아、거제낭종적효과,시일항괄합추엄적기술방법.술후3개월시료효평개최가시점.
Objective To evaluate the effects of fenestrating decompression of odontogenic cyst in mixed dentition children.Methods Twenty-eight patients were included in the study. Thirty-four deciduous teeth in the odontogenic cyst were extracted and the buccal bone of 5 cases were partially removed for the purpose of exposion. The double drainage-tubes were placed in the cystic space and fixed on bone plate with ligature wires. The cystic was irrigated with antibiotic solutions daily. All the patients were followed-up by 1 month, 3 months and 6 months after operation. Clinical and panoramic radiograph examination was conducted, and the results of treatment were analyzed according to Nakamura's method.Results The major diameters of cysts were progressively reduced after operation, with difference between 1 month and 3 months, and without difference between 3 months and 6 months. Three months after operation, the effect of fenestrating decompression was evaluated as extremely effective (67.86%), moderately effective (28.57%), and poorly effective (3.57%). And the total effective rate was 96.43% as the same as cure rate of one year later. Bone regeneration was noticed by radiographs. The displaced permanent tooth bud basically returned to its normal position and initially erupted. The method for clinical use was well accepted by the children.Conclusion The treatment of odontogenic cysts in mixed dentition with fenestrating decompression had the advantage of inducing permanent tooth eruption, protecting permanent tooth bud and curing cyst. It was a safe, reliable,and effective procedure in children's odontogenic cyst of mixed dentition. The optimal time to evaluate the treatment was 3 months after operation.