Clinical Treatment Analysis Of Cystic Lesions Of The Mandible

Objective:To evaluate the effects of curettage,decompression,resection of thejaws on mandibular cystic lesions.Methods:122cases of mandibular cystic lesions form2002to2011. The inclusioncriteria for the panoramic photography in mandibular cystic lesions and the maximumdiameter is more than1cm.The clinical analysis of the lesion composition, agedistribution, site of lesion, course of disease, preoperative symptoms, the largestdiameter of the lesion, clinical treatment to evaluate the clinical effect,the recurrencerate was followed up.Results:1. Patient sex, age, course of disease：122cases of mandibular cystic lesions,male82cases, female40cases;the ratio is about2:1. The age distribution in10~74years old, the median age is36years old. Occurred in20~50years old. Commonlesions in periapical cyst (n=58,47.6%) and keratocystic odontogenic tumor(n=51,41.8%). Keratocystic odontogenic tumor and periapical cyst patients agedistributions obey a normal distribution, age, treatment duration were compared, nostatistical significance(P>0.05). Medical causes for facial swelling, or occasionallyfound in conventional radiography. The course for a minimum of1weeks, the longest3years. Visiting time in more than half a month (n=47,38.5%). Because the mandiblevolume is larger, thicker wall, lesions along the bone marrow cavity growth, facialswelling is not obvious, the swelling is not easy to be found. So some patients up tomore than half a year time.2. Recurrence:Periapical cyst accounted for mandibular cystic lesions in47.6%,and the operation of simple enucleation have reached good results, follow-up showed norecurrence. Follow up of45cases with complete keratocystic odontogenic tumorclinical analysis, the effect of intralesional curettage with drug treatment is better thanthe simple application of curettage, and has statistical significance(P<0.05). 3. Other postoperative complications:The main postoperative complicationsincluded postoperative body temperature increased.The lesser cystic cavity nottamponade, large cystic cavity to pack indoform gauze or placement in bone powder.Bone cavity to pack iodoform gauze or bone powder,postoperative body temperaturecontrast has no statistically significant(P>0.05). Nerve injury such as lower lipparesthesia, angular motion limited. The cavity in some cases is larger, and with theinferior alveolar neurovascular bundle distance, after curettage have different degrees oflower lip numbing symptoms, the follow-up of symptoms can be gradually restored.The cavity is located in the mandibular ramus, to the submandibular approach operation,part of a marginal mandibular branch of the facial nerve injury induced by angularmovement restriction, follow-up observation of the symptoms recovered well.Conclusions:1.With the preservation of medical and functional surgery development,mandibular cystic lesions using curettage or resection indications gradually transferredfrom the absolute indications for relative indications. At the same time the jaw regionresection indications with histopathological and clinical cognitive gradually narrowing.2.Keratocystic odontogenic tumor, unicystic ameloblastoma and so easy to relapsecases, application of auxiliary drugs such as carbolic acid treatment bone cavity, caneffectively reduce the recurrence rate.3.Applicable to the decompression or marsupialization case, involving toothpreservation, improved mandibular functional treatment is worth popularizing.4.With auxiliary examination method constantly updated in peri operation period,it helps the clinician to provide a better reference for the operation design of mandibularcystic lesions.