術後長期観察した濾胞性歯嚢胞の一症例

A 4-year 5-month-old boy appeared at our hospital with dental caries. The boy continued to receive regular dental examination after treatment of the caries, and at 9 years 7 months of age, he complained of painless swelling of the mandibular left molar region. After stomatic examination, radiography and histopathological examination, a follicular dental cyst of the mandibular left second premolar tooth involvimg the dental germ was diagnosed. In addition, orthopantomography revealed a follicular dental cyst of the maxillary left first premolar tooth involving the dental germ. Fenestration surgery was performed on both regions. Ten months after surgery, the mandibular second premolar tooth began to erupt such that the top of the cuspid of the tooth on the buccal and lingual sides was visible macroscopically. However, since there was insufficient space (for the growing tooth), the first molar tooth was moved distally so that it was contained in the dental arch.<BR>Three months after surgery, the maxillary first premolar tooth erupted to occupy more than onethird of its crown. This tooth, however, had mesioclination that was likely to interfer with the erupting canine tooth. The tooth was therefore moved distally so that the canine tooth and the firest premolar tooth were led into the dental arch. An Orthopantomogram taken at 10 months after surgery showed that the radiolusent figure of the cyst was considerably reduced, suggesting that the cyst was being replaced with new bone.<BR>At 3 years 8 month after surgery, although the roots of the maxillary first premolar tooth and the mandibular second premolar tooth were curved and shorter than the controls on the other side, the apexes of these teeth had been closed, forming roots, indicating that treatment had been successful.<BR>On the basis of this present experience, we conclude that fenestration is a very useful surgical treatment for follicular dental cyst in younger patients and that displaced dental germ can be replaced in the dental arch using appropriate treatment.