단방낭종성 법랑아세포종의 적출술 후 재발 경향에 관한 연구
A STUDY ON THE PROGNOSIS AFTER ENUCLEAT10N IN THE UNICYSTIC AMELOBLASTOMA
정영수, 이의웅,
소속 상세정보
정영수 ( ) - 연세대학교 의과대학 소아과학교실
이의웅 ( ) - 연세대학교 치과대학 구강악안면외과학교실
KMID : 0355619980240030346
Abstract
Ⅴ. 결 론
1990년 1월부터 1997년 10월까지 만 7년 10개월간 연세대학교 치과대학병원 구강악안면외
과에 내원하여 조직학적으로 단방낭종성 법랑아세포종으로 진단 받고 술후 6개월이상 추적
관찰하였던 환자 22명을 대상으로 하여 이들 환자들의 임상병상기록, 방사선사진, 조직병리
학적 소견 등을 참고하여 환자의 주소, 연령 및 성별 빈도,부위별 빈도, 방사선사진 소견,조
직학적 유형, 추적관찰 기간 및 재발율 등에 대해 분석하여 조직병리학적 유형에 따른 재발
율 및 임상 양태에 관해 연구하여 다음의 결론을 얻었다.
1. 환자의 주소는 무통성 및 통증성 종창이 19례(86.4%)로 가장 많았고, 감각 이상이 2례
(9.1%), 배농이 1례(4.5%)의 순 이었다.
2. 연령별 빈도는 10대가 12례(54.5%)로 가장 많았으며 20대가 8례(36.5%)로 10대와 20대
가 총 22례 중 20례(91%)를 나타내었고, 평균 연령은 20.5세였다. 한편, 성별의 비율은
남성이 13례로 여성의 9례에 비해 1.4 : 1로 높았다.
3. 부위별 빈도는 22례 모두 하악골에서 발생하였으며 골체부가 15례 (68.2%)로 가장 호
발하였고, 상행지부가 6례 (27.2%), 정중부가 1례 (4.5%) 순이 었다.
4. 방사선학적 소견은 총 22례 중 단방성이 18례(81.8%)로 다방성 4례(182%)에 비해 빈발
하였고 매복치와 연관된 경우는 다방성 18례 중 15례(83.3%), 다방성 4례 중 3례(75%)
를 보였다.
5. Ackermann등의 조직학적 분류법에 따른 유형은 결체조직 침입형이 14례(8.6%), 낭종
강형, 망상형이 각각 4례(183%) 씩이었다.
6. 관찰 기간은 적출술후 6개월에서 8년 미만으로 평균 3.4년이었으며,총 22례 중 재발된
1례(L5%)는 결체조직 침입형이 었다.
이러한 성적을 근거로 하여 환자의 기능, 심미성, 정신적인 문제 등을 고려할 때 조직학적
유형에 상관없이 보존적 치료법인 적출술이 적합하다고 판단되었다.
#초록#
Since the apparent development of ameloblastoma in the wall of a dentigerous cyst
was first described by Cahn in 1933. many colleagues have reported the ameloblastoma
originated odontogenic cyst. In 1970. Vickers and Gorlin published specific histologic
criterria of the ameloblastoma originated odontogenic cyst, and in 1977, robinson and
Martinez referred to this variant as unicystic ameloblastoma in which the tesponse to
encleation or curettage was found to be fanorable with low recurrence rate. This lesion
was divided into 3 Groups (luminal, plexiform, connective tissue invasion type) according
to the histopathologic feature by Ackeymann etc. in 1988, and they recommended radical
treatment In connective tlssue Invasion type.
Conservative enucleation and currettge have been reported the choice treatment
compared with conventional ameloblastoma. which has represented low recurrent rate,
but the study on the prognosis after enucletion according to the histologic subtypes of
the unlcystic ameloblastoma has been rare.
This study is to invested the recurrence and clinical features of 22 ameloblastomas
which have been experienced by enucleation as trearment method from January 1990 to
October 1997 in Dental College Hospital of Yonsei University. The results obtained are
as follows.
1. The most common patients complains were painless or painful swelling of jaw(19
cases, 86.4%). dysthesia (2 cases, 9.1%), pus discharge (1 case, 4.5%) were next In
order.
2. The most frequent age was 2nd decade which was 12 cases(54.5%), and next
frequent age was 3rd decade which was 8 cases (36.5%). The average age was 20.5
years old, and sex ratio was 1.4:1 (male female).
3. All 22 cases were developed in the mandible, and body area occupied 15cases
(68.2%), ramus area was 6 Cases(27.2%) and symphysis area was 1 case (4.5%).
4. Radiographically, unilocular type was 81.8%, and the cases related with impacted
tooth were ular type and 3 cases (75%) In multllocular type.
5. According to histologic subtype by Ackermann's classification, luminal type and
were 4case(18.2%) respeclively, connective tissue type was 12 cases (63.6%).
6. Average follow-up period was 3.4 years, and the recurrence was 1 case(4.5%) of
total 22 cases, which was connective tissue Invasion type (7.14%) histologically.
Based on the above results, when patient's function, esthetics, and paychologic factor
are considered,the enucleation was adequarte primary treatment modality In any
histologic type of the unlcystic ameloblastoma
키워드
Unlcystic Ameloblastoma; Histologic subtype; Enucleation; Recurrence rate;
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