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患者芦××,男性,17岁,主诉左下颌部膨隆2年,近来增大伴疼痛,不能咬(牙合)。全身检查无殊。专科检查;外观面部左右不对称,左下颌角及体部膨隆,面颌畸形,左下颌可触及7×5×3cm包块,边界清,无触痛,局部皮肤无变色及溃疡。口内粘膜正常,4567颊沟区隆起,可触及明显乒乓感,567牙冠明显舌向移位倾斜,Ⅱ度松动。 X线摄片示:左下颌角及体部有明显囊性阴影,边界清楚,下颌角部囊腔内含有一磨牙阴影。567根端位于囊腔。X线片诊断:左下颌含牙囊肿。囊腔穿刺为淡黄色脓性液体,镜检有脓球、白细胞、少量红细胞、胆固醇结晶。治疗经过:局麻下拔除7,作为引流减压口,即有大量脓性液溢出,用3％双氧水及生理盐水反复冲洗,吸干,4％碘酊轻涂囊腔,碘纺纱条松填,每周换药一次,经换药3次,囊腔内有膜性片状坏死组织脱落冲出,脓性臭味基本消失。2个月摄片见囊内牙由下颌角部向(牙合)方生长,面部膨隆逐渐消退。9个月囊内牙齿向牙槽嵴生长,左颏孔重现清晰,囊腔骨质增生,透亮区范围明显缩小,面形对称。15个月囊内磨牙出现正常牙根,已萌出至牙龈,左右下颌骨密度对称。
Patients Lu × ×, male, 17 years old, complained of left lower extremity bulging 2 years, recently increased with pain, can not bite (occlusion). No special body check. Specialist examination; appearance of left and right facial asymmetry, left mandibular angle and body bulging, facial deformity, left mandibular palpable 7 × 5 × 3cm mass, clear boundary, no tenderness, local skin discoloration and ulcers. Mouth mucosa normal, 4567 buccal area uplift, can reach significant ping-pong flu, 567 crown obvious tongue tilt shift, Ⅱ degree loosening. X-ray showed: the left mandibular angle and body have obvious cystic shadow, clear boundary, the mandibular corner of the cyst contains a molar shadow. 567 root end located in the cyst. X-ray diagnosis: left mandibular dental cyst. Cyst puncture is light yellow purulent liquid, microscopic examination of pus ball, white blood cells, a small amount of red blood cells, cholesterol crystals. After treatment: local anesthetic removal 7, as the drainage port decompression, that is, a large number of purulent fluid overflow, with 3% hydrogen peroxide and saline repeatedly washed, sucked dry, 4% iodine tincture light cavity, Dressing once a week, the dressing 3 times, cystic lumen membrane necrosis tissue shedding, purulent odor disappeared. 2 months to see the capsule capsule by the mandibular angle to the (occlusal) side growth, facial swelling subsided. 9 months capsule to the alveolar ridge growth of the crescent, left mental foramen clear, cystic hyperplasia, translucent area was significantly reduced, surface symmetry. 15 months normal occlusion of the root canal cyst, has erupted to the gums, symmetrical about the mandibular density.