国际口腔医学杂志

国际口腔医学杂志 ›› 2026, Vol. 53 ›› Issue (3): 344-351.doi: 10.7518/gjkq.2026215

• 论著 • 上一篇    

基于锥形束CT的下颌牙源性囊肿患者12个月回顾性研究

张宝田(),熊宇韬,李章澳,鞠锐,刘伟,曾维,刘畅,汤炜()   

  1. 口腔疾病防治全国重点实验室 国家口腔医学中心 口腔疾病国家临床医学研究中心 四川大学华西口腔医院口腔颌面部创伤与整形外科 成都 610041
  • 收稿日期:2024-11-14 修回日期:2025-11-11 出版日期:2026-05-01 发布日期:2026-04-24
  • 通讯作者: 汤炜
  • 作者简介:张宝田，博士，Email：baotianzhang@foxmail.com
  • 基金资助:
    四川省自然科学基金(2024NSFSC0659);四川大学华西口腔医院探索与研发项目(RD-03-202303)

A 12-month longitudinal evaluation using cone beam computed tomography in patients with mandibular odontogenic cysts

Baotian Zhang(),Yutao Xiong,Zhang’ao Li,Rui Ju,Wei Liu,Wei Zeng,Chang Liu,Wei Tang()   

  1. State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Oral and Maxillofacial Trauma and Plastic Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2024-11-14 Revised:2025-11-11 Online:2026-05-01 Published:2026-04-24
  • Contact: Wei Tang
  • Supported by:
    Sichuan Science and Technology Program(2024NSFSC0659);Research and Develop Program of West China School of Stomatology, Sichuan University(RD-03-202303)

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摘要：

目的 基于锥形束CT（CBCT）图像，探讨下颌骨牙源性囊肿刮治术后复发的预后因素。 方法 回顾性分析2017—2021年在四川大学华西口腔医院接受下颌牙源性囊肿刮治术的患者。收集其临床基线资料和组织学诊断，并通过术前及术后6、12个月的CBCT数据，测量囊肿的最长直径、体积及灰度值。采用单因素分析、重复测量方差分析和多因素Logistic回归分析，探讨影响囊肿复发的潜在因素。 结果 共纳入90例患者，平均年龄为（38.4±15.5）岁。其中含牙囊肿26例，根尖囊肿30例，牙源性角化囊肿34例。3种不同组织学诊断的囊肿在随时间变化中，其最长直径表现出显著差异。多因素Logistic回归分析显示，病理诊断是影响牙源性囊肿刮治术后复发的唯一独立因素。 结论 单纯的组织学诊断与囊肿复发率密切相关，尤其像牙源性角化囊肿具有较高复发率的牙源性囊肿，需进行更加密切的随访管理。

关键词: 牙源性囊肿, 牙源性角化囊肿, 锥形束CT, 预后, 队列研究

Abstract:

Objective This study aimed to investigate the prognostic factors associated with the recurrence of mandibular odontogenic cysts post-enucleation via cone beam computed tomography (CBCT) images. Methods Patients who underwent enucleation for mandibular odontogenic cysts in West China Hospital of Stomatology, Sichuan University were retrospectively selected from 2017 to 2021. Their clinical baseline data and histological diagnoses were collected, as well as measurements (longest diameters, volumes, and grey values) based on CBCT data before the surgery and at 6 and 12 months after the surgery. Univariate analyses, repeated measures ANOVA, and multivariate Logistic regression were conducted. Results A total of 90 patients aged 38.4±15.5 years were included in this study, including 26 patients with dentigerous cysts, 30 with radicular cysts, and 34 with odontogenic keratocysts. We found a significant difference in longest diameters across three histological diagnoses over time. The results of multivariate Logistic regression analysis indicated that pa-thological diagnosis was the sole independent influen-cing factor for the recurrence of odontogenic cyst after enucleation. Conclusion Histological diagnosis alone was correlated with the recurrence rate. Odontogenic cysts with high recurrence rates such as odontogenic keratocysts require close follow-up.

Key words: odontogenic cyst, odontogenic keratocyst, cone beam computed tomography, prognosis, cohort study

中图分类号: 

  • R782

图 1

典型病例A：水平面；B：矢状面；C：冠状面；D：囊肿分割三维重建；E：囊性病变放射学指标量化。"

图 2

纳入排除流程图"

表 1

患者基线特征"

因素DCRCOKCF/χ2值P值
年龄/岁37.6±18.537.6±14.540.0±14.30.1830.833
性别/例女1316150.5890.804
男131419
D1/mm43.3±7.642.1±7.542.8±6.00.2160.806
V1/mm310 097.5±2 960.39 833.9±3 329.49 894.9±2 474.00.0610.941
GV1203.9±41.9201.3±37.9204.1±41.20.0470.954
GVSD178.7±31.394.3±37.187.9±32.61.4960.230

表 2

治愈组与复发组预后因素的单因素比较"

因素治愈组（n=76）复发组（n=14）F/χ2值P值
年龄/岁38.1±15.839.6±14.50.1110.740
性别/例女3680.4520.569
男406
组织学诊断/例DC2608.8940.010*
RC255
OKC259
D1/mm42.5±7.144.0±6.40.5400.464
V1/mm39 794.2±2 851.410 687.4±3 092.61.1310.291
GV1202.1±38.2208.7±49.60.3250.570
GVSD188.5±33.581.3±37.10.5340.467

表 3

RM-ANOVA结果"

因素DVGV
时期T1D1（42.7±7.0）V1（9 933.1±2 890.5）GV1（203.1±39.9）
T2D2（34.9±5.7）V2（6 762.3±1 979.0）GV2（285.9±53.1）
T3D3（4.8±11.3）V3（814.8±1 979.4）GV3（423.3±58.8）
P值时间0.000*0.000*0.000*
年龄0.8300.3330.352
性别0.6650.6630.471
组织学诊断0.2270.6770.543
时间×年龄0.7570.4590.739
时间×性别0.5020.8120.522
时间×组织学诊断0.016*0.0660.460

表 4

多因素Logistic回归分析（Enter法）"

因素回归系数标准误差wald χ2P值OR（95%CI）
年龄0.0200.0250.6300.4270.816（0.536，1.243）
性别（以女性为对照组）0.8560.355
男性0.6550.7080.8560.3551.924（0.481，7.701）
组织学诊断（以DC为对照组）1.0160.602
RC-20.4237 571.6540.0000.9980.000（0.000，-）
OKC-0.7010.6951.0160.3140.496（0.127，1.939）
D1-0.2030.2150.8940.3440.816（0.536，1.243）
V10.0010.0001.6630.1971.001（1.000，1.002）
GV10.0090.0081.1400.2861.009（0.992，1.026）
GVSD1-0.0100.0101.0300.3100.990（0.970，1.010）
回归模型截距β?-0.7784.8490.0260.873-

表 5

多因素Logistic回归分析（Forward Wald法）"

变量回归系数标准误差wald χ2P值OR（95%CI）
组织学诊断（以DC为对照组）0.8830.643
RC-20.1817 882.4900.0000.9980.000（0.000，-）
OKC-0.5880.6250.8830.3470.556（0.163，1.893）
回归模型截距β?-1.0220.3896.9070.009*-

图 3

治愈组（蓝色）与复发组（红色）在T1、T2、T3三个时间点的影像学指标分布A：最长直径；B：体积；C：灰度值平均值。"

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