TWO CASES OF DENTIGEROUS CYSTS TREATED BY MARSUPIALIZATION

조대술을 이용한 함치성낭종의 치험례

Dentigerous cyst is a cyst arising by a seperation of follicles from around the anatomical crown of an unerupted tooth within the jaws. The dentigerous cyst is seen during routine radiographic examination. It is detected radiographically as a sharply delineated, round or oval, unilocular, homogeneous, and radiolucent area within which there is the crown of an unerupted tooth. The histological appearance of the dentigerous cyst is usually attached to the tooth at the cementoenamel junction and the sac lined by a thin, regular. stratified squamous epithelium. The dentigerous cyst can be treated by two surgical procedures: enucleation or marsupialization. The size and location of the lesion usually dictates the surgical procedures. The marsupialization consists of the removal of only a portion of the wall of the cyst to make the remaining cystic lining continous with the oral mucosa. The cyst, deprived of its supporting hydrostatic pressure, gradually shrinks until it is obliterated. The marsupialization is the best way to conserve the tooth affected by a dentigerous cyst and to permit its eruption. especially in a young person. Main advantages of the marsupialization are its relative simplicity and its conservation with respect to adjacent important structures. In marsupialization technique, a plugger can be constructed, if necessary, to maintain the opening and prevent food debris from entering the cystic cavity. However, the disadvantage is the potentiality of leaving pathologic tissues. Therefore frequent recall appointments are advisable.

낭종은 환자의 연령, 낭종의 종류 및 위치에 따라 치료방법을 선택하는 것이 바람직하며, 환자의 연령이 어린 경우에는 조대술을 통하여 낭종에 이환된 치아를 가능한 보존시키는 것이 바람직한 것으로 생각된다. 낭종에 포함되었던 치아는 조대술로 낭종을 제거후에 생리적인 맹출이 이루어지는 것을 관찰할 수 있었으며 기능도 정상적으로 수행하는 것으로 판단된다. 그러나, 조대술을 이용하여 시술한 후에는 맹출된 치아에 병리조직이 잔존되어 재발의 가능성이 있으므로 주기적인 관찰이 요구될 것으로 생각된다.