氫氧磷灰石顆粒充填於角質性囊腫剜出後之下顎骨缺損－觀察5年餘之病例

Particulate Hydroxylapatite Grafting in the Mandibular Defect after Enucleation of an Odontogenic Keratocyst-A Case with 5-year Follow-up

郭英雄(Ying-Shiung Kuo) ； 李正喆(Jang-Jaer Lee) ； 郭生興(Sang-Heng Kok) ； 江俊斌(Chun-Pin Chiang) ； 林長春(Chiang-Chuen Lin)

《中華民國口腔顎面外科學會雜誌》 3卷2期 (1992/09) Pp. 51-57

https://doi.org/10.7104/CJOMS.199209.0051

摘要

36歲男性患者，右側下顎第二大臼齒至左側第二小臼齒間有一多房狀角質性囊腫，抽取時有黃色液體及白色固體物，右側門牙、犬齒及第一小臼齒均無牙齒活性試驗反應。在全身麻醉下，施行囊腫剜出術及右側下顎第一大臼齒至左側第一小臼齒間之根尖切除術，剜出後立即以15 gm氫氧磷灰石顆粒充填於顎骨缺損處，並予縫合。術後右側下顎第一、第二大臼齒間頰側粘膜裂開而感染，造成氫氧磷灰石顆粒部份流失，經右側下顎第二大臼齒根管治療及沖洗傷口後而痊癒。術後觀察5年多，復發3次，對於高再發率之角質性囊腫，作者建議完全剜出，且不宜用氫氧磷灰石顆粒充填於顎骨缺損處。

關鍵字

氫氧磷灰石顆粒 ； 角質性囊腫

並列摘要

A 36-year-old man had a polycystic keratocyst in the mandible extended from the right second molar to the second premolar of the left side. Aspiration yielded yellowish fluid mixed with some whitish semisolid material. Vitality tests of the right lateral incisor, canine and first premolar were negative. Under general anesthesia, the cyst was enucleated and apicoectomies of the teeth from the right first molar to the left first premolar were performed. The mandibular defect was immediately filled with 15 gm hydroxylapatite particles and the soft tissue was closed as routine. In the healing period, the wound at the buccal gingiva opposite the right first and second molars was dehisced and infected. Some hydroxylapatite particles were lost in that area. After appropriate wound care and root canal therapy of the right second molar, the wound eventually healed. In the follow-up period of more than 5 years, there were 3 occasions of recurrence. The authors recommend that, for such lesion as keratocyst with high recurrence rate, it is not suitable to graft the jaw defect with hydroxylapatite particles after complete eradication of the lesion.

並列關鍵字

Hydroxylapatite particle ； Keratocyst