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치원성 각화 낭종의 임상 방사선학적 연구
CLlNICAL AND RADIOLOGIC STUDY OF ODONTOGENIC KERATOCYST

치과방사선 1984년 14권 1호 p.27 ~ 38

김성래, 박덕영,

소속 상세정보

김성래 ( ) - 서울대학교
박덕영 ( ) - 서울대학교 치과대학 치과방사선학교실

KMID : 0378219840140010027

Abstract

치원성 각화 낭종의 임상적 방사선학적 양상을 연구하였다. 32명의 환자(21명의 남자, 11
명의 여자)를 이 연구를 위하여 사용하였다. 환자들의 기록과 방사선사진을 통하여 성별 및
연령의 분포, 호발부위, 방사선사진의 양상, 재발율 임상적 소견들을 조사하였던 바 아래와
같은 결과를 얻었다.
1. 남성이 여성에 비해 약 2배 호발하였고, 10대와 20대에서 가장 많이 발생하였다.
2. 호발부위는 하악의 구치에서 하악지에 이르는 부위였고 하악골이 상악골에 비해 호발
하였다.
3. 원기성 낭종에서 각화성 변화를 일으킨 것이 가장 많았다.
4. 최근의 흡수를 많이 보였으며, 하악골에서 경계는 원형과 부재형 (scalloped)이 거의 등
등히 나타났고 상악골에서는 대부분 원형의 단방형 낭종이었다.
5. 높은 재발율을 보였다.
6. 감염이 되어있는 경우가 많았다.
#초록#
The term odontogenic keratocyst for all odontogenic cysts, showing keratinization of
epithlium, regardless of type, was first suggested by Philipsen in 1956. These
odontogenic keratocyst can be distinguished from other odontogenic cysts in clinical
behaviors and histologic features.
Pindborg and Hansen discovered 30 odontogenic keratocysts from 792 cysts and
presented their clinical, radiographic and histologic characteristics.
Payne clinically classified 103 odontogenic keratocysts which corresponded with the
critiera of odotogenic keratocyst that had been suggested by Pindborg, and was
especially interested in recurrence after surgical treatment. He did follow-up check (6
months to 18 years) on 20 patients and got 45 per cent of recurrence rate.
Donoff and his colleagues detected 16 odontogenic keratocysts among 326 cysts (48
per cent incidence) through microscopic examination.
There was no odontogenic keratocyst in 241 radicular cysts and all the 4 dentigerous
cysts were odontogenic keratocyst, which conformed to the results in 1967 Sockolene
and Shear had advocated that the origin of all odontogenic keratocyst was primordial.
Referring to 'daughter' cysts in their microscopic study, they observed the isolated
cystic epithelial lining from the underlying mesenchyme, and suggested the role for its
cause, Donoff also reported the enzymatic mechanism of collagenase in the growth of
odontogenic keratocyst.
Brannon closely analysed the clinical features and microscopic appearance of 321
odontogenic keratocyst. According to this study, 5.1 per cent of all odontogenic
keratocysts appeared in basal cell nevus syndrome and 5.8 per cent developed in the
patient with multiple cysts, from which he suggested the correlation of odontogenic
keratocyst with multiple cysts.
In summary, odontogenic keratocyst occurs most frequently in the second and third
decades and at the mandibular third molar region, and shows slight predilection in male.
It has high recurrence rate after surgical treatment, which is the important reason why
we must differentiate it from other lesions before surgical procedures.
The radiographic appearance of odontogenic keratocyst cannot be distinguished from
that of other intrabony cysts. Frequently its lumen, densely filled with keratin, will
cause the usual radiolucent cyst-like image to have hazy appearance.
Some times, it may have scalloped borders and even occur with a multilocular
appearance.
The purpose of this article is to define further clinical behaviors and radiographic
appearances of odontogenic keratocyst developed in jaws, with special interest in
recurrence rate which is generally high.
Ⅰ. Materials and Methods
Materials
32 patients whose microscopic examinations were verified as odontogenic keratocyst
were examined in this study. Among them 22 patients were from Seoul National
University Hospital, 5 from Kyung Hee University Hospital and 5 from Yon Sei
University Hospital.
Method
Under the radiographs of 21 males and 11 females, the following details were
examined, and in all possible cases, patient's records were also investigated. In order to
confirm recurrence after surgical treatment, follow-up was done in all possible cases.
1. Distribution by sex and age
2. Location
3. Distribution of cysts according to type
4. Radiographic appearances
a. resorption of dental roots
b. types: unilocular and multilocular
c. border: smooth round and scalloped
d. haziness and expansion of cortical plates
5. Recurrence
6. Clinical findings