摘要
目的:对大型颌骨囊性病损进行开窗减压术后的缩减速率进行测算,分析可能的相关影响因素及病损体积缩减规律。方法:46例初诊全景片显示颌骨囊性病损直径大于3 cm的患者,对其进行开窗减压术。术后每3月进行复诊并拍摄锥形束CT(CBCT),导入体积测算软件MIMICS,分析测量患者病损的体积变化规律,及其与性别、年龄、病损初始体积、病损病理类型、是否含牙等相关因素的关系。结果:随着开窗时间的延长,病损体积的缩减速率逐渐减慢,到达500 d后,保持相对稳定。性别和年龄对于病损体积变化均无影响。3种病理类型患者的绝对缩减体积和绝对缩减速率与初始体积成正相关,相对缩减速率与治疗时间成负相关,相对缩减体积与治疗时间成正相关。牙源性囊肿有多房者绝对缩减体积与绝对缩减速率更快;成釉细胞瘤组患者中,病损内含牙未拔的患者要比不含牙者有更小的初始体积,绝对缩减速率也相应更小。结论:患者性别、年龄和病理类型对颌骨囊性病损的缩减速率并无显著影响;初始体积则与囊性病变缩减速率成正相关。病损体积缩减速率随时间而下降,直至病损体积不再发生明显变化。
Objective:The aims of the present study were to assess the effects of decompression before enucleation for the treatment of large cystic lesions and to compare the rate of decrease of the lesions volume every three months so as to provide some guidance for clinicians on when to do the enucleations.Methods:The study included 46 patients with large mandibular lesions(panoramic radiograph diameter>3 cm).Decompression was used to release intraluminal pressure and decrease the volume of the lesion,along with an obturator.Cone Bean computed tomography(CBCT)was applied to all patients before and every three months after decompression.Volumetric analysis was performed using software MIMICS 20.0,which is designed for 3-dimensional measurement of volumes.Other variables,such as age,gender,initial volume,pathological types,and whether contain impacted teeth were recorded.Results:With the extension of decompression time,the reduction rate of lesion gradually slowed down.The lesion volume remained relatively stable after the 500th day.Gender and age had no effect on lesion volume reduction rules.For all the patients of the three pathological types,the absolute volume reduction and the absolute rate of reduction were positively correlated with the initial volume.The relative rate of reduction was negatively correlated with the decompression time,while the relative volume reduction was positively correlated with decompression time.For odontogenic cyst patients,those who with multilocular cysts have a faster absolutely reduced volume and absolute reduction rate;For ameloblastoma patients,those who with impacted teeth but not extracted in the same time with decompression have a smaller initial volume than that of the patients without impacted teeth,and the absolute reduction rate is slower.Conclusions:Gender,age and pathological type of the patients had no significant effect on the rate of reduction of jaw cystic lesions.Initial volume was positively correlated with the rate of cyst shrinkage.The reduction rate of lesion volume decreased with time until lesion volume no longer changed significantly.
作者
陈玥
丁旭
胡建
CHEN Yue;DING Xu;HU Jian(Jiangsu Key Laboratory of Oral Diseases, Department of Prosthetics, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China;Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China)
出处
《口腔生物医学》
2020年第2期116-119,124,共5页
Oral Biomedicine
基金
江苏高校优势学科建设工程资助项目(2018-87)。
关键词
颌骨囊性病变
开窗减压术
缩减速率
jaw cystic lesion
decompression
volume reduction rate
