함치성낭종의 임상 및 병리조직학적 연구

CLINICAL & HISTOPATHOLOGICAL STUDY OF DENTIGEROUS CYST

The dentigerous cyst originates through alteration of the reduced enamel epithelium after the crown of the tooth has been completely formed, with accumulation of fluid between the reduced enamel epitheliun and the tooth crown. It is very important clinically because several serious potential complications exist stemming from the dentigerous cyst, besides simply the possibility of recurrence following incomplete surgical removal. The author has studied clinically and histopathologically about one hundred and seventeen biopsy specimens and charts collected from department of oral surgery and oral pathology, College of dentistry, Yonsei University, Seoul National University and Kyung Hee University during the period of January, 1977. to August, 1982. which had been diagnosed clinically and radiologically as dentigerous cyst. The results were as followings: 1. The moat common complaints were swelling and pain. Other symptoms included pus discharge, delayed eruption of tooth and unhealed postextraction wound. 2. In the sex incidence of 92 cases of dentigerous cyst, 61 cases(67%) were in male and 31 cases(34%) in females. The average age was 23.7 years, and more decreased in the incidence after 30 years. 3. The most common location of the dentigerous cyst was the anterior regions of the maxilla, where were many supernumerary teeth. 4. The histologic pattern of epithelium lining cysts showed mainly stratified squamous epithelium, and ciliated epithelium were fecund partly in association with nasal and maxillary sinus mucosa. 5. Heterogenous histopathologic features of dentigerous cyst showed keratinization in 13 cases, daughter cyst 3 cases & severe epithelial hyperplasia 10 cases. 6. Among the 117 dentigerous cyst diagnosed clinically and radiologically, 92 cases(79%) were dentigerous cyst, 7 cases mural ameloblastoma, 1 case suggested epidermoid carcinoma other differential diagnosis 17 cases(14.5%). 7. In treatment of dentigerous cyst, complete enucleation using frozen section, histopathologic examination and post-op clouted observation and care were very important to prevent the potential complications and recurrence of dentigerous cyst.