国际口腔医学杂志

国际口腔医学杂志 ›› 2023, Vol. 50 ›› Issue (1): 100-107.doi: 10.7518/gjkq.2023023

• 综述 • 上一篇    下一篇

腺牙源性囊肿的临床研究进展

秦艺纯(),谭学莲,黄定明()   

  1. 口腔疾病研究国家重点实验室 国家口腔疾病临床医学研究中心四川大学华西口腔医院牙体牙髓病科 成都 610041
  • 收稿日期:2022-07-07 修回日期:2022-10-14 出版日期:2023-01-01 发布日期:2023-01-09
  • 通讯作者: 黄定明
  • 作者简介:秦艺纯，学士，Email：yichunqin2000@163.com
  • 基金资助:
    四川省重点研发项目(2021YFS0031);四川大学华西口腔医院探索与研发项目(LCYJ2019-6)

Clinical research progress on glandular odontogenic cyst

Qin Yichun(),Tan Xuelian,Huang Dingming.()   

  1. State Key La-boratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2022-07-07 Revised:2022-10-14 Online:2023-01-01 Published:2023-01-09
  • Contact: Dingming. Huang
  • Supported by:
    the Funding of Key Research and Development Program of Sichuan Province(2021-YFS0031);the Research and Develop Program, West China Hospital of Stomatology, Sichuan University(LCYJ2019-6)

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摘要：

腺牙源性囊肿是一种较为罕见的口腔颌面部囊肿，相关文献报道较少，且多以散在病例报告的形式出现。此类囊肿具有侵袭性强、复发率高、预后不良，危害性大的特点。此外，腺牙源性囊肿常表现为发生于下颌骨的无痛性肿胀。该囊肿临床症状缺乏典型性，影像学上无明显特征，易与其他牙源性囊肿、肿瘤等病变混淆。本文总结了腺牙源性囊肿的流行病学特点，重点突出了诊断要点、鉴别诊断途径及常见治疗方法，旨在帮助口腔医生更好地诊治此类疾病。

关键词: 腺牙源性囊肿, 鉴别, 诊断, 治疗

Abstract:

Glandular odontogenic cyst is a relatively rare oral and maxillofacial cyst, which is not commonly reported in the literature and is mostly in the form of scattered case reports. However, it has characteristics of aggressive behavior, high recurrence rate, poor prognosis, and harmful influence. In addition, glandular odontogenic cyst often presents as painless swelling in the mandible. Hence, it is difficult to be distinguished from other odontogenic cysts and tumors because it lacks typical clinical symptoms and radiological features. Therefore, this review summarizes the epidemiological characteristics, highlighting the key diagnostic points, differential diagnosis, and common treatment methods, which are aimed at helping dentists to timely diagnose and treat the disease.

Key words: glandular odontogenic cyst, differentiate, diagnosis, treatment

中图分类号: 

  • R 781.34+3

表 1

GOC的鉴别诊断要点"

疾病临床特点影像学组织病理免疫组化基因检测好发位置
（低级别）中央性黏液表皮样癌女性多于男性；面部常不对称；可有下颌骨麻木—薄层上皮衬里；实质性上皮增生；中间细胞CK13、 CK19多阴性；CK7、CK8、CK18多阳性；乳腺抑丝蛋白高表达MAML2基因重排阳性下颌磨牙及升支

牙源性角化

囊肿

2个发病高峰；可伴痣样基底细胞癌综合征—上皮衬里厚度均匀；囊壁可见子囊/上皮岛CK16、CK17阳性；CK19阴性P53、PTCH基因表达下颌磨牙及升支

发育性根侧

囊肿

复发率较低直径多小于1 cm缺乏腺样结构、纤毛上皮——下颌尖牙、前磨牙

单囊型成釉

细胞瘤

青年人好发单囊；唇颊侧颌骨膨胀；可见边缘骨硬化增生；牙根锯齿状吸收单腔内衬成釉细胞瘤样上皮钙结合蛋白阳性；平足蛋白阳性—下颌磨牙区

多囊型成釉

细胞瘤

—多囊；唇颊侧颌骨膨胀；可见边缘骨硬化增生；牙根锯齿状吸收实性和囊性部分；滤泡型、丛状型常见——下颌磨牙及升支
根尖周囊肿常伴龋齿、残根、死髓牙—上皮细胞间水肿、炎细胞浸润平足蛋白阳性—上颌前牙
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