骨板翻盖术联合可吸收板固定治疗下颌骨大型囊肿的效果观察

doi:10.7518/hxkq.2024.2023438

华西口腔医学杂志 ›› 2024, Vol. 42 ›› Issue (4): 470-475.doi: 10.7518/hxkq.2024.2023438

骨板翻盖术联合可吸收板固定治疗下颌骨大型囊肿的效果观察

胡一帆¹^,²(), 孙清妍¹^,², 王晨燚³, 翟孝庭⁴, 姜华¹(), 刘华蔚¹()

^1.中国人民解放军总医院第一医学中心口腔科，北京 100853
^2.解放军医学院，北京 100853
^3.北京市顺义区医院口腔科，北京 101300
^4.首都医科大学附属北京口腔医院口腔修复科，北京 100050

收稿日期:2023-12-13 修回日期:2024-04-20 出版日期:2024-08-01 发布日期:2024-07-17
通讯作者: 姜华,刘华蔚 E-mail:clairhu1@163.com;jh1225@163.com;liuhuawei840222@126.com
作者简介:胡一帆，医师，硕士，E-mail：clairhu1@163.com

Effectiveness of bone plate reduction combined with resorbable plate fixation in the treatment of large mandibular cysts

Hu Yifan¹^,²(), Sun Qingyan¹^,², Wang Chenyi³, Zhai Xiaoting⁴, Jiang Hua¹(), Liu Huawei¹()

^1.Dept. of Stomatology, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
^2.Medical School of Chinese PLA, Beijing 100853, China
^3.Dept. of Stomatology, Beijing Shunyi Hospital, Beijing 101300, China
^4.Dept. of Prosthodontics, Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China

Received:2023-12-13 Revised:2024-04-20 Online:2024-08-01 Published:2024-07-17
Contact: Jiang Hua,Liu Huawei E-mail:clairhu1@163.com;jh1225@163.com;liuhuawei840222@126.com

摘要/Abstract

摘要：

目的观察骨板翻盖术联合可吸收板治疗口腔颌面部大型下颌骨囊肿的临床效果。方法选取2017年10月—2022年9月在中国人民解放军总医院第一医学中心口腔颌面外科诊治的唇（颊）侧皮质骨存在的大型下颌骨囊肿患者为研究对象，口内入路行骨板翻盖术，术后3、6和9个月定期随访进行锥形束计算机断层扫描（CBCT），观察术后患者恢复情况及影像学检查，评估该术式的临床效果。结果对11例唇（颊）侧皮质骨存在的下颌骨大型囊肿进行了评估。术前测量唇（颊）侧皮质骨的平均厚度约为（1.98±0.37）mm，骨板最薄处厚度平均为（0.73±0.17）mm，骨板最薄处约0.51 mm。术中囊腔均显露良好，手术顺利完成。术后创口一期愈合无感染，术后3、6、9个月的囊肿缩小率分别约为20.01%、41.76%、73.41%。用CBCT和MIMICS软件测量颌骨的骨质密度，术后3、6、9个月囊肿区成骨密度约为313.78、555.85、657.45 HU。患者和观察者视觉模拟量表评估患者颌面部外形较术前无明显变化。结论骨板翻盖术是治疗唇（颊）侧皮质骨存在的口腔颌面部大型下颌骨囊肿的有效方法。

关键词: 下颌骨大型囊肿, 骨板翻盖术, 骨愈合, 治疗效果

Abstract:

Objective This study aims to observe the clinical effect of bone plate reduction in combination with a resorbable plate on large mandibular cysts. Methods Between October 2017 and September 2022, patients with large mandibular cysts in the presence of labial and buccal cortical bone were involved in the study. Intraoral approach was performed for bone plate reduction. Cone beam computed tomography (CBCT) scan was reviewed at 3, 6, and 9 months postoperatively to observe postoperative complications. Osteogenic results were assessed at these times to determine the clinical outcomes of this procedure. Results Eleven cases with large mandibular cysts in the presence of cortical bone were evaluated. The average thickness of the cortical bone on the labial and buccal sides was measured to be about (1.98±0.37) mm before surgery, with a mean value of (0.73±0.17) mm at the thinnest part of the plate and up to 0.51 mm at the thinnest part of the plate. The cystic cavities were well revealed during the surgeries, which were completed successfully. Postoperatively, the wounds healed in one stage without infection. The percentages of cyst shrinkage were 20.01%, 41.76%, and 73.41% at 3, 6, and 9 months after surgery, respectively. Quantitative measurement of bone mineral density in the jaws by CBCT with MIMICS software. The bone mineral densities of the adult bone were 313.78, 555.85, and 657.45 HU at the 3, 6, and 9 month time intervals, respectively. No significant change in the patient’s maxillofacial appearance were observed from the preoperative period as assessed by the patient’s and observer’s visual analog scale. Conclusion Bone plate reduction is an effective treatment for large mandibular cysts of the oral and maxillofacial region with the presence of cortical bone.

Key words: large mandibular cysts, bone plate reduction, bone healing, therapeutic effects

中图分类号:

R782.1

胡一帆, 孙清妍, 王晨燚, 翟孝庭, 姜华, 刘华蔚. 骨板翻盖术联合可吸收板固定治疗下颌骨大型囊肿的效果观察[J]. 华西口腔医学杂志, 2024, 42(4): 470-475.

Hu Yifan, Sun Qingyan, Wang Chenyi, Zhai Xiaoting, Jiang Hua, Liu Huawei. Effectiveness of bone plate reduction combined with resorbable plate fixation in the treatment of large mandibular cysts[J]. West China Journal of Stomatology, 2024, 42(4): 470-475.

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项目	性别	年龄/岁	囊肿位置	病理诊断	囊肿大小/mm×mm×mm	唇（颊）侧骨板最薄处厚度/mm	唇（颊）侧骨板平均厚度/mm	囊肿体积/mm³	术后3个月复查囊肿体积/mm³	术后6个月复查囊肿体积/mm³	术后9个月复查囊肿体积/mm³
病例1	男	35	左侧下颌骨体部	牙源性角化囊肿	39.80×15.20×20.80	0.96	2.35±0.41	52 681	38 910	24 540	12 696
病例2	男	21	右侧下颌骨体部	含牙囊肿	38.00×8.30×20.20	0.69	1.66±0.58	26 673	20 004	12 207	6 934
病例3	男	31	下颌骨体部	牙源性角化囊肿	31.10×9.00×12.50	0.92	1.94±0.91	14 648	11 088	6 508	3 954
病例4	男	31	右侧下颌骨体部	根尖囊肿	20.30×6.70×13.90	0.73	1.54±0.72	7 915	5 540	3 502	1 920
病例5	男	41	左侧下颌骨体部和升支	牙源性角化囊肿	32.70×66.00×20.00	0.51	2.21±1.59	180 713	153 407	103 970	47 863
病例6	男	66	下颌骨体部	牙源性角化囊肿	60.00×10.00×16.00	0.54	1.73±0.78	120 576	95 076	72 834	36 195
病例7	男	64	左侧下颌骨体部和下颌角	牙源性角化囊肿	80.00×24.10×12.30	0.52	2.52±1.43	99 284	74 896	53 911	24 709
病例8	男	68	右侧下颌骨体部和下颌角	牙源性角化囊肿	54.00×20.00×12.00	0.64	1.58±0.60	54 259	43 407	25 153	14 368
病例9	男	43	左侧下颌骨体部	含牙囊肿	32.50×17.30×8.10	0.86	2.25±0.97	19 067	13 346	7 887	5 133
病例10	女	37	左侧下颌骨体部	牙源性角化囊肿	34.20×12.00×14.10	0.64	1.53±0.77	24 226	18 080	10 721	6 542
病例11	男	48	左侧下颌骨体部	牙源性角化囊肿	22.30×11.80×31.00	1.02	2.47±0.91	34 152	25 438	15 519	9 312

测量项目	平均值	中位值	斯皮尔曼相关系数	Sig.（双尾）
患者VAS评分	8.92±0.31	9.00	0.744**	0.009
医生VAS评分	9.28±0.28	9.30

骨板翻盖术联合可吸收板固定治疗下颌骨大型囊肿的效果观察

Effectiveness of bone plate reduction combined with resorbable plate fixation in the treatment of large mandibular cysts

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