| Objective This study aims to evaluate the current status and treatment of patients with cystic lesions of the jaw in the Second Affiliated Hospital of Dalian Medical University,explore their clinical features,and compare the efficacy of different surgical procedures and the clinical outcome of different bone filling materials,to provide a theoretical basis for further improving the diagnosis and treatment of cystic lesions of the jaw.Methods A retrospective study was conducted by reviewing the case files of patients treated for cystic lesions of the jaw in the department of Oral and Maxillofacial Surgery at the Second Affiliated Hospital of Dalian Medical University from June 2014 to June 2018.362 patients diagnosed with cystic lesions of the jaw were selected for this study.Data was analyzed based on the histopathology of the cyst,clinical features including the patient's age,gender,chief complaint,the site of the lesion,surgical technique performed,bone filling material used,prognosis etc.The follow-up data was recorded and collected in detail,and the clinical outcome analyzed.Results1.The current status of cystic lesions of the jaw: A total of 362 patients were included in the study.The four most common types of cystic lesions of the jaw observed were:Radicular cyst(57.46%),Dentigerous cyst(13.26%),Odontogenic keratocyst(10.50%)and Ameloblastoma(7.46%).These accounted for 88.67% of the total cystic lesions of the jaw.It's more common in men,The ratio of male to female is 1.24:1.The youngest being 8 years old to the eldest being 91 years old,The mean age was(41.94±17.91)years old;Highest incidence of cystic lesions of the jaw was observed between 31-40 years of age.The most common site of the lesion is the maxillary anterior region,followed by the angle of the mandible and ascending ramus,and the mandibular posterior region.Most of the patients come with the chief complaint of swelling over the face or jaw and other facial deformities.2.Treatment plan and efficacy of cystic lesions of the jaw: A total of 283 patients included in the study were successfully followed up.The follow-up rate was 78.18%.The follow-up period ranged from 3 months to 48 months,and the mean follow-up period was16.67 months.Enucleation was performed in 307 of the cases,236 patients were successfully followed up.The 6-month efficacy rate was 192/236=81.36% and the12-month efficacy rate was 199/236=84.32%.Marsupialization was done in 31 cases,24 patients.were successfully followed up.The 6-month efficacy rate was 17/24 =70.83%and the 12-month efficacy rate was 21/24=87.5%.18 patients underwent resection of benign jaw lesions(all followed up)and 7 patients partial resection of the jaws,6patients were successfully followed up.All patients were followed up for more than 24 months without recurrence.The study compared the two kinds of operation with large cystic lesions of the jaw(maximum diameter of bone defect ? 4.0 cm).At 6 months and 12 months post-operatively,the residual bony defect area in the marsupialization group was smaller than in the enucleation group and the difference was statistically significant.Therefore,we can conclude that the therapeutic effect of marsupialization is better than that of enucleation in large cystic lesion.The study also comparison of the effects of different bone filling materials,the parameters of the curved tomogram were measured at 1 day,3 months,6 months and 12 months after the operation.The results showed that the bone mineral density increased at 3 months,6 months and 12 months after operation(P<0.01).It can be considered that the Autogenous Tooth Bone Graft Material has an advantage in degradation rate and osteogenesis,compared with the traditional material(Hydroxyapatite).Conclusions1.The current status of cystic lesions of the jaw:the most common histopathological type is apical cyst.The most common histopathological type is apical cyst.Highest incidence of cystic lesions of the jaw was observed between 31-40 years of age.The most common site of the lesion is the maxillary anterior region,followed by the angle of the mandible and ascending ramus,and the mandibular posterior region.Most of the patients come with the chief complaint of swelling over the face or jaw and other facial deformities.2.The 6-month efficacy rate was 192/236=81.36% and the 12-month efficacy rate was199/236=84.32% in Enucleation.The 6-month efficacy rate was 17/24 =70.83% and the 12-month efficacy rate was 21/24=87.5% in Marsupialization.patient underwent resection of benign jaw lesions and partial resection of the jaws were followed up for more than 24 months without recurrence.3.For the treatment of large cystic lesions of the jaw,the area of the bony defect in the marsupialization group was reduced faster and the osteogenesis was faster compared to the enucleation group.4.For the choice of filling materials in the bony defect area of the cystic lesion of the jaw,the Autogenous Tooth Bone Graft Material has an advantage in degradation rate and osteogenesis,compared with the traditional material(Hydroxyapatite). |
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