- 期刊
Treatment of an Inflammatory Dentigerous Cyst: Case Report
發炎性含齒囊腫與其治療：病例報告
摘要
A Dentigerous cyst is a type of odontogenic cyst and frequently found in young patients. It is usually asymptomatic and associated with the crown of an unerupted or impacted tooth. An inflammatory dentigerous cyst develops as a result of the intra-follicular spread of periapical inflammation from the overlying primary tooth. This case report presents a large dentigerous cyst in the mandible of a 11-year-old girl patient. Clinical examination and panoramic X-ray revealed a swelling mass in the right mandibular region. The lesion displaced the underlying permanent second premolar. An inflammatory dentigerous cyst with infection source from the right mandibular second primary molar was diagnosed. Treatment started with the extraction of right mandibular second primary molar under block anesthesia, followed by marsupialization of the cyst. An obturator was fitted for decompression and keeping the surgical window patent. After 7 months of follow-up, the cystic lesion subsided. Orthodontic treatment was done within 12 months to assist eruption and alignment of impacted premolar. In conclusion, the combination of marsupialization with orthodontic extrusion is a conservative, efficient protocol that preserves cyst-associated teeth and promotes their eruption and bone healing.
並列摘要
發炎性含齒囊腫是好發於年輕病患的齒源性囊腫，通常沒有臨床症狀，病灶特徵常包覆著一顆阻生或未萌發的的恆齒。病灶發生原因為，未萌發恆牙上方的乳牙因深度齲齒或其他原因失去活性，發炎物質自乳牙根尖擴散到下方未萌發恆牙外層的牙齒囊泡，造成液體堆積在牙冠和囊泡之間，進而形成囊腫。本案例呈現一例大型發炎性含齒囊腫發生於十一歲青少年患者的右下顎骨區域。該患者因右下顎骨區腫脹已經數週來本院所求診，經臨床和影像學檢查發現，其病灶發炎來源為失去活性的右下第二乳臼齒，進而造成囊腫與右下第二小臼齒阻生。我們使用的治療方法為囊腫造袋術，在局部麻醉下拔除右下第二乳臼齒後，對囊腫做引流並給予閉孔器來保持囊腫開口的通暢性。經治療後七個月追蹤，該囊腫病灶消退並有明顯骨癒合。後續進行十二個月矯正治療，將右下第二小臼齒拉出並排列整齊。臨床上對於發炎性含齒囊腫伴隨阻生牙齒的病例，使用囊腫造袋術合併矯正治療，是一相對保守，能保存牙胚且能消除囊腫、促進病灶區域骨頭的治療方式。