Clinical and Histopathological Study of the Odontogenic Keratocyst - A Follow-up Study of 16 Cases

齒源性角化囊腫之臨床及組織病理學之研究：16例之追蹤報告

陳中和(Chung-Ho Chen) ； 林正仲(Cheng-Chung Lin)

《The Kaohsiung Journal of Medical Sciences》 2卷9期 (1986/09) Pp. 601-607

https://doi.org/10.6452/KJMS.198609.0601

摘要

由1979到1984的5年間，從高雄醫學院口腔顎面外科及口腔病理科之檔案中查出213例的齒源性囊腫，其中有16例為角化囊腫，其發生率為7.5%。這16例角化囊腫在臨床初診及X光片之診斷時為始基性囊腫的有7例，含齒性囊腫的有6例，根尖牙周囊腫的有3例。病例的年齡從14歲到44歲，主要的年齡分佈群在20到39歲之間佔87.5%。所有的病例中，男性有7例，女性9例，無甚明顯的性別偏好。由病灶發生的部位來說，有13例（81.25%）是發生在下顎，只有3例是發生在上顎區。在下顎的13例中有10例是發生在下顎第3大臼齒區及下顎枝的位置。X光檢查發現所有的病例皆是單一囊腫，其中7例為單房性放射線透射區，9例為多房性放射線透射區。6例含有未萌發的牙齒，在這6例中有5例其未萌出之牙區為下顎第3大臼齒。所有病灶區的牙齒未發現有牙根吸收的現象。組織病理學之所見其上皮層厚度萎縮的有10例，萎縮與變長并存的有5例。角化不全的有12例，2例為正常角質化，另外二例則角化不全與正常角質化并存。所有的病例皆經施行摘除術再加上囊腫周圍骨骼廣泛性地磨除。其中有3例再發，再發率為 18.75%。再發的時間為術後三個月，一年，及五年。所有病例目前仍繼續追蹤檢查中。

並列摘要

Sixteen cases of odontogenic keratocysts (OKC) were studied within the documented files, of 213 odontogenic cysts from the Department of Oral Pathology and Oral and Maxillofacial Surgery, Kaohsiung Medical College. The overall incidence of OKC was 7.5% of odontogenic cysts examined. Those 16 cases, according to the clinical impressions, included primordial cysts (7 cases), dentigerous cysts (6 cases) and apicoperiodontal (radicular) cysts (3 cases). The ages of patients ranged from 14 to 44 years. The peak age incidence was between third and fourth decades (87.5%). There were no apparent sex predilection, 7 males and 9 females. According to the site of lesion, 13 (81.25%) cases were at the mandible and 3 were at the maxilla. Ten out of 13 cases of the mandibular cyst were at the molar region and/or the ramus. Roentgenographs showed 7 cases with unilocular and 9 cases with multilocular radiolucencies. There were 6 cases with unerupted teeth, but with no phenomenon of root resorption. Histopathological examination revealed the lining epithelium was atrophic on 10 cases, atrophic plus elongated rete pegs on 5 cases, and elongated rete pegs on one case. Complete parakeratosis in 12 cases, orthokeratosis in 2 cases and both parakeratosis and orthokeratosis was the treatment of choice for all cases. Recurrence was found in 3 cases with a recurrent rate of 18.75%.

並列關鍵字

odontogenic cyst ； odontogenic keratocyst