上顎大臼齒牙髓壞死與上頜竇根尖囊腫－病例報告

Pulp Necrosis of Left Maxillary Molar and Radicular Cyst in the Maxillary Sinus: A Case Report

徐維敏(Wei-Min Hsu) ； 吳秉翰(Ping-Han Wu) ； 程季芳(Chi-Fang Cheng) ； 張一勤(Yi-Chin Chang)

《北市醫學雜誌》 預刊文章 Pp. 1-6

https://doi.org/10.6200/TCMJ.202406/PP.0013

摘要

根尖囊腫是齒源性囊腫中最常見的類型，臨床上以根管治療後配合手術剜除囊腫，必要時合併拔除患齒。本病例左臉反覆腫痛，於一年前完成左上第一大臼齒根管治療。X光攝影檢查發現左上臼齒區有一類囊腫病灶侵犯上頷竇，臆斷為根尖囊腫。左上第二大臼齒於根管治療期間，因持續腫痛，症狀逐漸加劇，病人接受拔牙處置。術後兩周持續有急性鼻竇炎症狀，使用抗生素治療未見腫痛症狀改善，遂轉診至醫學中心評估，施行囊腫剜除術並拔除左上第一與第三大臼齒。病理切片證實為上頷竇根尖囊腫。術後9個月，病灶無復發跡象。

關鍵字

根尖囊腫 ； 齒源性囊腫 ； 上頷竇齒源性囊腫 ； 齒源性鼻竇炎

並列摘要

The radicular cyst is the most common of the odontogenic cystic lesions. Treatment options include conventional endodontic therapy and surgical enucleation, with extraction of the offending tooth if necessary. The present case had root canal treatment for the upper left first molar one year ago because of constant left face swelling and pain. Radiographic examination revealed a large unilocular radiolucency involving the maxillary sinus and adjacent molars. During conventional endodontic therapy the patient had his upper left second molar extracted due to exacerbation of the offending tooth. The ensuing symptoms of acute maxillary sinusitis persisted for over two weeks. The patient was referred to the medical center for cyst enucleation via the transoral approach along with the extraction of his upper left first and third molars. Histopathological examination confirmed a radicular cyst with cavity lined with non-keratinized stratified squamous epithelium. There were no signs of recurrence nine months later after surgery.

並列關鍵字

radicular cyst ； odontogenic cyst ； odontogenic maxillary cyst ； odontogenic maxillary sinusitis