• 대한소아치과학회지
• /
• 제25권3호
• /
• pp.613-618
• /
• 1998

A dentigerous cyst is an epithelium-lined sac that surrounds the crown of an impacted, embedded, or unerupted tooth. Many surgical procedures have been described for the elimination of dentigerous cyst, but they can be devided into two basic group: enucleation and marsupialization. Marsupialization is a conservative technique which allows the reduction or elimination of a cystic lesion by making it an accessory compartment to the oral cavity and it is the best way to conserve a tooth affected by dentigerous cyst and to permit its eruption, especially in young patient. After using marsupialization to treat dentigerous cyst associated with the crown of unerupted premolar in young patient, the results were as follows: 1. Reduction of bony expansion and rapid bone regeneration without infection and recurrence were observed. 2. Normally spontaneous eruption of involved teeth were permitted, as well as loss of affected tooth was avoided. 3. Follow-up examinations revealed no complication and recurrence.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제47권1호
• /
• pp.40-46
• /
• 2021

Marsupialization is widely used as a primary treatment modality for reducing size of large cysts. However, there is no recommendation for specific duration of marsupialization. In addition, Carnoy's solution usually is applied at the time of enucleation as a fixative agent. In this report, we present an appropriate marsupialization duration of ameloblastoma involving two unerupted teeth. In this present study, marsupialization using a Foley catheter was performed in two cases of ameloblastoma of the mandible involving two adjacent impacted teeth. Carnoy's solution was applied for 3-5 minutes after enucleation in both patients. Periodically during marsupialization, the size of the radiolucency was measured in panoramic view, and clinical examination was performed. No remarkable paresthesia or soft tissue injury was observed after application of Carnoy's solution or during follow-up. We recommend 12 to 16 weeks as an adequate marsupialization duration for a large ameloblastoma involving two impacted teeth based on increased radiopacity along the margins of the lesions. Poor oral hygiene was an issue after 12 weeks of marsupialization in one case. There were no remarkable complications with Carnoy's solution in either case. The Foley tube has a two-way system that is more effective for irrigating the cavity than is the conventional one-way system.

• 대한치과의사협회지
• /
• 제53권8호
• /
• pp.569-580
• /
• 2015

Cyst is a closed sac, having a distinct membrane and division compared to the nearby tissue. Most cysts in the oro-maxillofacial area are odontogenic origin and found most commonly by oral and maxillofacial surgeons. Enucleation is considered as a definitive therapy in the management of these cysts. However, to select the treatment method for large cyst, consideration of position of the cyst, size and accessibility to main structure are needed. Marsupialization is a minimal invasive technique to treat large odontogenic cyst and tumor without damage to adjacent important structures. This study was undertaken to describe three cases of odontogenic cysts and tumors of jaws that were successfully treated with enucleation after marsupialization.

• 대한소아치과학회지
• /
• 제42권1호
• /
• pp.22-29
• /
• 2015

본 연구는 최근 12년간 하악 소구치에 발생한 함치성 낭을 가진 환자에 대하여 조대술을 시행한 후 해당 치아의 맹출 양상과 이에 영향을 미칠 수 있는 매복치의 깊이, 경사도, 매복치 치근의 발달 정도 등과의 관계를 평가하였다. 조대술을 시행 한 후 93%의 하악 소구치가 자발적으로 맹출 했으며, 낭종에 이환된 소구치는 이환되지 않은 대조군보다 조대술 후 더 빠르게 맹출 되었고 각도 변화도 더 크게 나타났다(p < 0.05). 이환된 소구치의 치근 발육정도가 낮을수록 맹출 속도가 빠르게 나타났고(p < 0.05), 치축각 변화량은 커지는 경향을 보였으나 통계학적으로 유의하지 않았다(p > 0.05). 대부분의 경우 맹출 속도와 치축각의 변화는 조대술 후 6개월 이내에 나타났다. 이 연구의 결과를 통해 함치성 낭에 이환된 치아의 조대술 후 자발적인 맹출 유도양상에 대한 정보를 제공하여 적절한 진단을 통해 바람직한 치료계획을 수립하는데 도움을 줄 것이다.

• 대한소아치과학회지
• /
• 제25권2호
• /
• pp.268-276
• /
• 1998

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.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제35권6호
• /
• pp.411-419
• /
• 2009

Objective: The purpose of this study was to determine whether cyst enucleation would be done after marsupialization of large cystic lesion on the jaws or not, and if so, when it should be done. Patients & Methods: 12 patients with cystic lesion treated by marsupialization only and 10 patients with cystic lesion treated by marsupialization followed by enucleation were examined in this study. Postoperative clinical and radiographic examinations were performed at 1, 4, 7, 10, 13, 16, 19 months on 22 patients. Bone regeneration and reduction rate of the residual cystic cavities and bone density were evaluated with a analysis of digital panoramic radiographs. Also histological evaluation of the healing process was performed on 1 patient. Results: Uneventful healing and spontaneous bony filling of the residual cavities were observed in all cases. Postoperative radiographs showed that the size of the lesions was reduced for a few months, but the reduction rate of the residual cavity was minimized for 13~16 months after marsupialization. The bone density was increased 22.5 % after 19 months. Conclusion: This results suggest that the appropriate timing to perform enucleation would be 13~16 months after marsupialization. The state of healing process could be confirmed by histological examination and radiographic evaluation of bone density. Enucleation after marsupialization could be applied appropriately to reduce the periods of bone healing in large cystic lesion on the jaws.

• 구강회복응용과학지
• /
• 제34권3호
• /
• pp.246-250
• /
• 2018

법랑아 세포종은 치성 상피에서 기인한 양성 종양의 일종이다. 하악골에 가장 흔하게 발생하는 양성종양이며 공격적인 성장과 국소적 침범의 특징을 가진다. 그 중 단방성 법랑아 세포종은 방사선학적으로는 단방성의 특징을 가지며 병리학적으로는 낭종의 특징을 가진다. 낭종성 법랑아 세포종의 병소의 크기가 큰 경우 감압술 및 조대술이 보존적인 치료 방법으로 사용된다. 이 치료 방법의 목적은 병소의 크기를 줄여 완전 적출이 손쉽게 하며 악안면 부위 변형이나 신경 손상을 방지하는데 있다. 본 증례에서는 병소의 크기가 큰 낭종성 법랑아 세포종을 감압술 및 조대술로 성공적으로 치료한 치험례를 논문 고찰과 함께 보고하고자 한다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제34권2호
• /
• pp.216-219
• /
• 2008

Ameloblastoma is the most frequently accuring odontogenic tumor in mouth. The biologic behavior of this neoplasm is locally invasive tumor with a high rate of recurrence. But in case of unicystic ameloblastoma, it was known that the neoplasm can be treated by marsupialization and the recurrence rate is lower. In our clinic, we tried to treat one of ameloblastoma cases by marsupialization and finished the treatment by enucleation via intra-oral approach with sagittal ramus osteotomy. This is a report of that case about 29 years old female patient.

• 대한치과교정학회지
• /
• 제50권1호
• /
• pp.63-71
• /
• 2020

Odontogenic keratocysts (OKCs) are one of the most aggressive cysts in the oral and maxillofacial area because of their high recurrence rate and infiltrative behavior. In growing patients with OKCs, a radical treatment approach might cause numerous complications, including the disturbance of jaw growth and loss of the involved tooth. This case report describes successful comprehensive orthodontic treatment combined with marsupialization of the cyst in a young girl who exhibited an OKC with impacted teeth. The 10-year-old girl presented with an OKC extending from the mandibular symphysis through the left mandibular body, with ectopic impaction of the mandibular left canine and first premolar, as well as congenitally missing bilateral mandibular second premolars. Interestingly, spontaneous improvement of the positions of the ectopic impacted teeth, along with a reduction in the size of the cyst, occurred during marsupialization. The sequential use of removable and fixed appliances enabled orthodontic traction of the impacted teeth. The treatment outcome was stable at 2.5 years after the end of the treatment. We speculate that comprehensive orthodontic treatment combined with marsupialization can be an effective treatment strategy for patients with OKCs, especially when they are encountered in young, growing patients with impacted teeth.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제31권2호
• /
• pp.173-179
• /
• 2009

Dentigerous cyst is an odontogenic cyst which occurs in unerupted tooth crown. After the crown formation, enamel epithelium remnants surrounded continuously proliferates and it forms effusionfluid cyst and expands due to increased internal osmotic pressure. Treatments of cysts are mainly enucleation, marsupialization and de-compression. When deciding the way of treatment, the age of a patient, the anatomical circumstances, the region of lesion and the size of cyst should be considered. Marsupialization is that some parts of internal cystic wall would be converted into oral mucosa if the cyst is large size and is concerned about neighboring anatomic structure. It can be accompanied by enucleation later and eruption of related tooth can be possible. If there is a limitation of spontaneous tooth eruption, eruption of tooth can be induced by orthodontic apparatus. There were 3 patients had dentigerous cyst and underwent marsupialization, their impacted teeth had preserved and had induced eruption, all showing satisfactory results.