小児における歯性嚢胞の症例シリーズ

A Case Series of Dentigerous Cyst in Paediatric Patients at Our Tertiary Institution.

抄録

歯性嚢胞は下顎第三大臼歯、上顎犬歯、上顎第三大臼歯、稀に中切歯など、萌出歯や発育中の歯に発生し、通常は無症状ですが、直径2cmを超える大きさになると腫脹、軽度知覚過敏、歯の動揺、変位などの症状を呈するようになります。歯性嚢胞は20～30歳代に多く、小児では比較的少なく、生後10年以内に4～9％の割合で発生する。Ashwini Rural medical college & Hospital, Solapurの耳鼻咽喉科で行われた病院ベースの研究で、我々は小児患者の歯性嚢胞の3症例を報告した。歯性嚢胞は上顎永久側切歯、下顎永久前臼歯、下顎第二大臼歯に発生した。歯性嚢胞の仮診断は臨床的、X線学的、生化学的検査に基づくが、病理組織学的検査により診断が確定する。歯科オルソペンタモグラムは、歯性嚢胞の診断と局在の確認に役立ち、CT顔面写真は歯性嚢胞の拡大による骨への影響や合併症の確認に役立ちます。嚢胞性病変の核出術とそれに続く問題のある歯の抜歯は、嚢胞の完全な除去と未萌出の歯の萌出の機会を与えることの間の適切なバランスを与える、上顎と下顎に関連する歯性嚢胞に対する適切な治療方法である。

Dentigerous cysts involves erupted or developing teeth in decreasing order of frequency as mandibular third molars, the maxillary canines, the maxillary third molars with rare involvement of the central incisors & are usually asymptomatic but becomes symptomatic with symptoms such as swelling, mild sensitivity, tooth mobility and displacement when it reaches size > 2 cm in diameter. Dentigerous cysts are seen most commonly in 20-30 years age group with relative low frequency in children with proportion of 4-9% of these cysts occur in the first 10 years after birth. Hospital based study conducted in the Department of ENT at Ashwini Rural medical college & Hospital, Solapur in which we have reported a series of three cases of dentigerous cyst in paediatric patients. Dentigerous Cysts in our study were associated with maxillary permanent lateral incisor, mandibular permanent premolar, Mandibular second molar tooth in pediatric age group. Provisional diagnosis of Dentigerous cyst based on clinical, radiological & biochemical study but Histopathological examination confirms the diagnosis. Dental orthopentamogram aids in diagnosing and localizing the Dentigerous cyst and ct face in all views helps to see bony effects and complications due to expansion of Dentigerous cyst. Enucleation of the cystic lesion followed by extraction of the offending teeth is a suitable treatment modality for Dentigerous cyst associated with maxilla and mandible giving adequate balance between complete removal of cyst & giving chance for eruption of unerupted teeth.