顎嚢胞の核出術と嚢胞に侵された歯を残すための意図的な再植術の併用

Enucleation of jaw cyst combined with intentional replantation to retain cyst-involved teeth.

抄録

背景:

顎嚢胞は隣接歯根を深く侵すことが多く、歯の保存が困難である。このレトロスペクティブスタディの目的は、顎嚢胞摘出時に嚢胞に浸潤した歯を保存するために、嚢胞核出術と意図的再植術（IR）を併用する戦略の有効性を検討することである。

BACKGROUND: Jaw cysts often deeply involve adjacent tooth roots, making it difficult to preserve them. The purpose of this retrospective study was to investigate the effectiveness of an intentional replantation (IR) strategy combined with cyst enucleation in preserving cyst-involved teeth during jaw cyst removal.

材料と方法:

顎嚢胞と深在性歯牙を有する15名の患者が、IRと嚢胞核出術により治療された。術前に根管治療を受けた1例を除き、全例が手術中に根管治療を受けた。浸潤歯は抜歯し、IRと嚢胞核出術の前に根面を注意深く清掃した。臨床的愁訴、再植歯の安定性、歯根吸収などを指標として、患者を12～14ヵ月間フォローアップした。

MATERIALS AND METHODS: Fifteen patients with jaw cysts and deeply involved teeth were treated with IR and cyst enucleation. All patients received root canal therapy prior to surgery, except for one patient who received it during surgery. The involved teeth were extracted, and the root surface was carefully cleaned before IR and cyst enucleation. Patients were followed up for 12-14 months, with indicators including clinical complaints, replanted tooth stability, and root resorption.

結果:

嚢胞の再発は観察されず、すべての再植歯は良好な歯肉局所の状態で生存し、顕著な腫脹や退縮は認められなかった。レントゲン所見では、再植歯の周囲に明確な歯周スペースが認められた。1歯は咬合性外傷によるわずかな歯根吸収を認めたが、咬合調整により吸収は止まった。

RESULTS: No cyst recurrence was observed, and all replanted teeth survived with good local gingival condition and no marked swelling or recession. Radiographic findings showed clear periodontal space surrounding the replanted teeth. One replanted tooth exhibited slight root resorption due to occlusal trauma, but the resorption ceased after occlusal adjustment.

結論:

IRと嚢胞核出術の併用は、顎嚢胞を徹底的に洗浄し、嚢胞に関与した歯を保存するための効果的な戦略である。

CONCLUSIONS: IR combined with cyst enucleation is an effective strategy for thoroughly cleaning jaw cysts and preserving teeth involved in the cyst.