Maxillofacial Plastic and Reconstructive Surgery

Korean Association of Maxillofacial Plastic and Reconstructive Surgeons (대한악안면성형재건외과학회)
권호 표지

MARSUPIALIZATION IN RESOLVING DENTIGEROUS CYSTS: CASE REPORT

감압조대술을 이용한 함치성낭종의 치험례

  • Kim, Hyun-Woo (Dept. of Oral and Maxillofacial Surgery, Sanggye Paik Hospital, College of Medicine, Inje University) ;
  • Yoon, Kyu-Ho (Dept. of Oral and Maxillofacial Surgery, Sanggye Paik Hospital, College of Medicine, Inje University) ;
  • Park, Kwan-Soo (Dept. of Oral and Maxillofacial Surgery, Sanggye Paik Hospital, College of Medicine, Inje University) ;
  • Jung, Jung-Kwon (Dept. of Oral and Maxillofacial Surgery, Sanggye Paik Hospital, College of Medicine, Inje University) ;
  • Ban, Jae-Hyurk (Dept. of Oral and Maxillofacial Surgery, Sanggye Paik Hospital, College of Medicine, Inje University) ;
  • You, Myung-Soo (Dept. of Oral and Maxillofacial Surgery, Sanggye Paik Hospital, College of Medicine, Inje University)
  • 김현우 (인제대학교 의과대학 부속 상계백병원 구강악안면외과학교실) ;
  • 윤규호 (인제대학교 의과대학 부속 상계백병원 구강악안면외과학교실) ;
  • 박관수 (인제대학교 의과대학 부속 상계백병원 구강악안면외과학교실) ;
  • 정정권 (인제대학교 의과대학 부속 상계백병원 구강악안면외과학교실) ;
  • 반재혁 (인제대학교 의과대학 부속 상계백병원 구강악안면외과학교실) ;
  • 유명수 (인제대학교 의과대학 부속 상계백병원 구강악안면외과학교실)
  • Published : 2005.01.31
Download PDF
⟨ Previous Next ⟩

Abstract

Dentigerous cyst is one of the most prevalent types of odontogenic cysts in the jaw. Usually dentigerous cysts begin to develope through an accumulation of fluid between remnants of the enamel organ and subjacent tooth crown which is developing or submerged. The teeth most often involved are mandibular third molars, maxillary canines, and mandibular premolars. And the cysts usually occur in the second or third decade of life. The treatment of dentigerous cysts-enucleation, marsupialization, and fenestration-is dictated by the size, environmental structures of the lesion, and desirability of conserving involved tooth. Marsupialization is a conservative technique which allows the reduction or elimination of cystic lesion by making it an accessory compartment of the oral cavity in the case where complete enucleation is not desirable. Marsupialization is thought to be the most suitable method of treatment for the conserving of the involved tooth, thus guiding eruption of it. We report the positive outcome got from marsupialization in dentigerous cysts with review of literature.

함치성낭종은 병소의 크기 및 인접 구조물과의 관계 등에 따라 개창술 및 적출술, 감압조대술 등 여러 방법으로 치료할 수 있다. 본 증례에서는 여러 함치성낭종의 치료를 위해 감압조대술 시행하였고, 수술 후 낭종 내부에 매복된 미성숙 영구치는 병소의 크기가 줄어듦에 따라 모두 정상 맹출하였다. 또한 하악 제3대구치를 포함하는 광법위한 크기의 함치성낭종에 소파술을 동반한 감압조대술을 시행한 결과, 낭막의 악성변이가 발견되었음에도 불구하고 인접 구조물의 손상 없이 이상적인 치료 결과를 얻었다. 감압조대술은 광범위한 병소의 적출 시 야기될 수 있는 악골 및 주위 인접 구조물의 손상을 최소화하고, 특히 젊은 환자에서 낭종 내에 포함된 영구치의 보존 및 맹출유도를 위한 가장 적절한 치료법이다. 그러나 수술 후에 지속적인 경과관찰 또한 치료계획에 포함되어야 한다.

Keywords

References

  1. Murakami A, Kawabata K, Suzuki A : Eruption of an impacted second premolar after marsupialization of a large dentigerous cyst; case report. Pediatric Dentistry 17 : 372, 1995
  2. Vincent B, Toddi E, Ronald S : Using fenestration technique to treat a large demtigesous cyst. JADA 128 : 201, 1997
  3. Boyczuk MP, Berger JR : Identifying a deciduous dentigerous cyat. JADA 126 : 643, 1995
  4. William MW, John TW, Robert WG : Marsupialization of dentigerous cyst of mandible: report of case. J Oral Surgery 29 : 742, 1971
  5. Gerard LL : The use of marsupialization in resolving a dentigerous cystic lesion. J Canad Dent Assn 8 : 569, 1985
  6. Main DM : Epithelial jaw cysts.: a clinicopathological reappraisal. Brit J Oral Surg 8: 114, 1970 https://doi.org/10.1016/S0007-117X(70)80002-6
  7. Main DM : Epithelial jaw cysts.: 10 years of the WHO classification. J Oral Pathol 14 : 1, 1985 https://doi.org/10.1111/j.1600-0714.1985.tb00459.x
  8. Benn A, Altini M : Dentigerous cysts of inflammatory orgin: A clinicopathological study. Oral Surg Oral Pathol 81 : 203, 1996 https://doi.org/10.1016/S1079-2104(96)80416-1
  9. Umit E : Interesting eruption of 4 teeth associated with a large dentigerous cyst in mandible by only marsupialization. J Oral Maxxilofac Surg 61 : 728, 2003 https://doi.org/10.1053/joms.2003.50145
  10. Mintz S, Alard M, Nour R : Extraoral removal of mandibular odontogenic dentigerous cysts: A report of 2 cases. J Oral Maxillofac Surg 59 : 1094, 2001 https://doi.org/10.1053/joms.2001.25857
  11. Miller CS, Bean LR : Pericoronal radiolucencies with and without radiopacities. Dent Clin North Am 38(1) : 51, 1994
  12. Martensson G : Cysts and carcinoma of the jaws. Oral Surg 8 : 673, 1955 https://doi.org/10.1016/0030-4220(55)90028-1
  13. Johnson LM, Sapp JP, McIntire DN : Squamous cell carcinoma arising in a dentigerous cyst. J Oral Maxillofac Surg 52 : 987, 1994 https://doi.org/10.1016/S0278-2391(10)80087-4
  14. Richard J : Spontaneous repositioning of displaced molars after marsupialization of a dentigerous cyst. JADA 102 : 655, 1981
  15. Whitlock RI, Jones JH : Squamous cell carcinoma of the jaw arising in a simple cyst. Oral Surg 24 : 530, 1967 https://doi.org/10.1016/0030-4220(67)90433-1
  16. Tuzum MS : Marsupialization of a cystic lesion to allow tooth eruption: A case report, Quintessence Int 28 : 283, 1997
  17. Takasi S, Koyama S : Guided eruption of an impacted second premolar associated with a dentigerous cyst in the maxillary sinus of a 6-year-old child. J Oral Maxillofac Surg 56 : 237, 1999 https://doi.org/10.1016/S0278-2391(98)90876-X
  18. Luz A, Jose LG ; Dentigrous cyst of mandibular second premolar in a five-year-old girl, related to non-vital primary molar removed one year earlier: a case report. J Clin pediatr Dent 22 : 155, 1998
  19. Golden AL, Foote J, Lally E : Dentigerous cyst of the maxillary sinus causing elevation of the orbital floor. Oral Surg 52 : 133, 1981 https://doi.org/10.1016/0030-4220(81)90308-X
  20. Nakamura N, Higuchi Y : Comparison of long results between different approaches to ameloblstoma. Oral Surg Oral Mrd Oral Pathol Oral Radiol Endod 93 : 12, 2002
  21. Vedtofte P, Hjongting HE, Jensen BN : Conservative surgical treatment of mandibular ameloblastomas. Int J Oral Surg 7 : 156, 1978 https://doi.org/10.1016/S0300-9785(78)80018-0
  22. Gardner DG, A pathologist's approach to the treatment of ameloblastoma. J Oral Maxillofac Surg 42 : 161, 1984 https://doi.org/10.1016/S0278-2391(84)80026-9
  23. Mullar H, Slootweg PJ : The ameloblastoma, the controversial approach to therapy. J Maxillofac Surg 13 : 79, 1985 https://doi.org/10.1016/S0301-0503(85)80021-7