非牙髓源性根尖周病鉴别诊断及治疗

doi:10.13701/j.cnki.kqyxyj.2022.06.004

口腔医学研究 ›› 2022, Vol. 38 ›› Issue (6): 505-508.DOI: 10.13701/j.cnki.kqyxyj.2022.06.004

非牙髓源性根尖周病鉴别诊断及治疗

曾康瑞, 夏文薇^*

上海交通大学医学院附属第九人民医院牙体牙髓科,上海交通大学口腔医学院, 国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室上海 200001

收稿日期:2021-02-23 出版日期:2022-06-28 发布日期:2022-06-23
通讯作者: * 夏文薇,E-mail:xwwall@sina.com
作者简介:曾康瑞(1996~),女,福建人,硕士在读,主要从事牙体牙髓相关临床及基础的研究。

Differential Diagnosis and Overview of Nonendodontic Periapical Lesions

ZENG Kangrui, XIA Wenwei^*

Department of Endodontics and Operative Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200001, China

Received:2021-02-23 Online:2022-06-28 Published:2022-06-23

摘要/Abstract

摘要： 非牙髓源性根尖周病是一组发生在根尖周区域的病变,易与牙髓来源性根尖周炎混淆,导致误诊误治。鉴别诊断主要依靠临床表现、影像学检查及牙髓活力测试。治疗方案需综合考虑病变的性质,根尖受累情况,牙髓活力等因素。本文就非牙髓源性根尖周病鉴别诊断和相关受累牙的治疗选择进行综述,旨在加深对疾病认识,为临床诊治提供参考。

关键词: 根尖周炎, 受累牙, 非牙髓源性, 鉴别诊断, 减压术

Abstract: Nonendodontic periapical lesions occur in the periapical area, which may lead to misdiagnosis and mistreatment when confused with pulp-derived periapical periodontitis. The differential diagnosis of nonendodontic periapical lesions mainly depends on clinical examination, imaging manifestations, and pulp vitality test. The nature of the lesion, the apical condition, and pulp vitality of the teeth involved in the lesion and other factors should be considered in determining the optimum treatment. In this review, we summarized the differential diagnosis of nonendodontic periapical lesions and the treatment of involved teeth, in order to deepen the understanding of the disease and provide reference for clinical diagnosis and treatment.

Key words: periapical periodontitis, involved teeth, nonendodontics, differential diagnosis, decompression

曾康瑞, 夏文薇. 非牙髓源性根尖周病鉴别诊断及治疗[J]. 口腔医学研究, 2022, 38(6): 505-508.

ZENG Kangrui, XIA Wenwei. Differential Diagnosis and Overview of Nonendodontic Periapical Lesions[J]. Journal of Oral Science Research, 2022, 38(6): 505-508.

参考文献

[1] Vieira CC, Pappen FG, Kirschnick LB, et al. A retrospective brazilian multicenter study of biopsies at the periapical area: Identification of cases of nonendodontic periapical lesions [J]. J Endod, 2020, 46(4): 490-495.
[2] Sirotheau Corrêa Pontes F, Paiva Fonseca F, Souza de Jesus A, et al. Nonendodontic lesions misdiagnosed as apical periodontitis lesions: series of case reports and review of literature [J]. J Endod, 2014, 40(1): 16-27.
[3] Huang HY, Chen YK, Ko EC, et al. Retrospective analysis of nonendodontic periapical lesions misdiagnosed as endodontic apical periodontitis lesions in a population of Taiwanese patients [J]. Clin Oral Investig, 2017, 21(6): 2077-2082.
[4] Guimarães GG, Perez DE, Netto JD, et al. Nonendodontic periapical lesions: a retrospective descriptive study in a Brazilian population [J]. Med Oral Patol Oral Cir Bucal, 2021, 26(4):e502-e509.
[5] Brody A, Zalatnai A, Csomo K, et al. Difficulties in the diagnosis of periapical translucencies and in the classification of cemento-osseous dysplasia [J]. BMC Oral Health, 2019, 19(1): 139.
[6] Shibata N, Inamoto K, Naitoh M, et al. Clinical assessment of cemento-osseous dysplasia based on three-dimensional diagnostic imaging: A case report [J]. Aust Endod J, 2021, 47(1): 105-112.
[7] Salvi AS, Patankar S, Desai K, et al. Focal cemento-osseous dysplasia: A case report with a review of literature [J]. J Oral Maxillofac Pathol, 2020, 24(Suppl 1): S15-S18.
[8] de Freitas Silva BS, Yamamoto-Silva FP, Sena-Filho M, et al. 20-year follow-up of recurrent glandular odontogenic cyst mimicking a periapical lesion [J]. J Endod, 2017, 43(11): 1915-1920.
[9] Schuch LF, Vieira CC, Uchoa Vasconcelos AC. Malignant lesions mimicking endodontic pathoses lesion: A systematic review [J]. J Endod, 2021, 47(2): 178-188.
[10] Shilkofski JA, Khan OA, Salib NK. Non-Hodgkin's lymphoma of the anterior maxilla mimicking a chronic apical abscess [J]. J Endod, 2020, 46(9): 1330-1336.
[11] Jalali P, Kim SG. Multiple periradicular radiolucencies mimicking endodontic lesions in renal osteodystrophy of the mandible: a case report [J]. Int Endod J, 2016, 49(7): 706-714.
[12] Peters SM, Pastagia J, Yoon AJ, et al. Langerhans cell histiocytosis mimicking periapical pathology in a 39-year-old man [J]. J Endod, 2017, 43(11): 1909-1914.
[13] Candeiro GTM, de Souza CVT, Chaves RSA, et al. Central giant cell granuloma mimicking a periapical lesion of endodontic origin: A case report [J]. Aust Endod J, 2020, 46(3): 381-386.
[14] 黄定明,傅裕杰,谭学莲.牙髓活力状态的临床判断之惑及解决之道[J].牙体牙髓牙周病学杂志,2017,27(8):431-436.
[15] 杨靖翚,袁国华.对牙髓活力测试方法的介绍与评价[J].口腔医学研究,2021,37(3):195-199.
[16] Lv M, You G, Wang J, et al. Identification of a novel ANO5 missense mutation in a Chinese family with familial florid osseous dysplasia [J]. J Hum Genet, 2019, 64(7): 599-607.
[17] 黄定明,甯佳丽,郑广宁,等.牙根尖周区病变的影像学诊断之惑与鉴别之道[J].国际口腔医学杂志,2017,44(3): 249-255.
[18] Torabinejad M, Fouad AE, Walton R. Endodontics: Principles and Practice [M]. Elsevier, 2014.
[19] Pace R, Cairo F, Giuliani V, et al. A diagnostic dilemma: endodontic lesion or odontogenic keratocyst? A case presentation [J]. Int Endod J, 2008, 41(9): 800-806.
[20] Macdonald D, Angelopoulos C, Scarfe WC. Cone beam computed tomography and maxillofacial diagnosis [M]. Cham; Springer International Publishing, 2018: 469-551.
[21] Torregrossa VR, Faria KM, Bicudo MM, et al. Metastatic cervical carcinoma of the jaw presenting as periapical disease [J]. Int Endod J, 2016, 49(2): 203-211.
[22] Patel S, Brown J, Semper M, et al. European society of endodontology position statement: Use of cone beam computed tomography in endodontics [J]. Int Endod J, 2019, 52(12): 1675-1678.
[23] de Carvalhosa AA, de Araújo Estrela CR, Borges AH, et al. 10-year follow-up of calcifying odontogenic cyst in the periapical region of vital maxillary central incisor [J]. J Endod, 2014, 40(10): 1695-1697.
[24] Pittl TL, Meier M, Hakl P, et al. Long-term observation of a large keratocystic odontogenic tumour of the mandible treated by a single enucleation procedure: A case report and literature review [J]. Int J Surg Case Rep, 2017, 34:119-122.
[25] 黄紫荆,胡晓莉.减压术在根尖囊肿治疗中的应用进展[J].口腔医学研究,2019,35(9): 22-25.
[26] de Molon RS, Verzola MH, Pires LC, et al. Five years follow-up of a keratocyst odontogenic tumor treated by marsupialization and enucleation: A case report and literature review [J]. Contemp Clin Dent, 2015, 6(Suppl 1): S106-S110.
[27] Liang YJ, He WJ, Zheng PB, et al. Inferior alveolar nerve function recovers after decompression of large mandibular cystic lesions [J]. Oral Dis, 2015, 21(5): 674-678.
[28] Ferrante MA. The assessment and management of peripheral nerve trauma [J]. Curr Treat Options Neurol, 2018, 20(7): 25.
[29] 陶谦, 何悦, 刘冰,等. 开窗治疗颌骨囊性病变的专家共识[J].口腔疾病防治,2020,28(2): 69-72.
[30] Cunha JF, Gomes CC, de Mesquita RA, et al. Clinicopathologic features associated with recurrence of the odontogenic keratocyst: a cohort retrospective analysis [J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2016, 121(6): 629-635.
[31] Karaca C, Dere KA, Er N, et al. Recurrence rate of odontogenic keratocyst treated by enucleation and peripheral ostectomy: Retrospective case series with up to 12 years of follow-up [J]. Med Oral Patol Oral Cir Bucal, 2018, 23(4): e443-e448.
[32] 王敬旭,高平,刘海潮.牙髓活力电测仪检测法在颌骨囊肿受累牙诊断中的应用[J].实用口腔医学杂志,2011,27(3):415-417.

非牙髓源性根尖周病鉴别诊断及治疗

Differential Diagnosis and Overview of Nonendodontic Periapical Lesions

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

[1]	李婷婷, 王超凡, 赵吉宏. 开窗减压术治疗下颌骨单囊型成釉细胞瘤1例[J]. 口腔医学研究, 2022, 38(3): 291-294.
[2]	孙熹, 张旗. 巨噬细胞极化在糖尿病合并根尖周炎中作用的研究[J]. 口腔医学研究, 2021, 37(5): 412-417.
[3]	郑立娟, 李浩然, 刘健伟, 韩冰, 陈小冬. 紫花前胡素通过降低OPN表达抑制根尖周炎进程[J]. 口腔医学研究, 2021, 37(3): 213-217.
[4]	李玲, 杨细虎, 李俊江. 乳牙根尖周炎对继承恒牙发育影响的影像学研究[J]. 口腔医学研究, 2021, 37(11): 994-998.
[5]	刘学军, 徐家敏. 牙髓血运重建术治疗年轻恒牙根尖周病变的临床及影像学评估[J]. 口腔医学研究, 2020, 36(7): 630-634.
[6]	张立刚, 易杰, 姚礼, 黄桂林, 胡小华, 张霓霓, 代敏. 单囊型成釉细胞瘤行开窗减压术联合刮治术的临床研究[J]. 口腔医学研究, 2020, 36(4): 341-345.
[7]	周焱, 王颖慧, 赵焕英, 尚佳健. IL-17在乳牙根尖周病损组织中的表达[J]. 口腔医学研究, 2020, 36(4): 365-368.
[8]	段聪聪, 韩冰. 颌骨囊性病变相关手术治疗的发展现状[J]. 口腔医学研究, 2020, 36(10): 898-901.
[9]	张利娟, 姜明, 李姗姗, 李帆, 张颖, 谭凯璇, 卢洁, 杨芳. 乳磨牙根尖周炎伴牙源性上颌窦炎及眶下间隙感染1例[J]. 口腔医学研究, 2020, 36(1): 87-88.
[10]	黄紫荆, 胡晓莉. 减压术在根尖囊肿治疗中的应用进展[J]. 口腔医学研究, 2019, 35(9): 837-840.
[11]	马典福, 陈帅, 肖素丽, 李萍萍, 黄晓晶. 慢性根尖周炎对大鼠血浆炎症因子及主动脉的影响[J]. 口腔医学研究, 2019, 35(9): 872-875.
[12]	赵恒越, 何文娟. HIV感染与非HIV感染患者慢性根尖周炎的炎性因子及免疫功能对比[J]. 口腔医学研究, 2019, 35(5): 461-465.
[13]	梁燕, 马文, 聂焱, 付帅, 张长彬, 崔庆赢, 王立冬, 黎明. 3D打印塞治器在下颌骨囊性病变中的应用[J]. 口腔医学研究, 2019, 35(12): 1153-1156.
[14]	张琪,李雨霖,马东洋. 耳颞部巨细胞肉芽肿1例[J]. 口腔医学研究, 2018, 34(9): 1026-1028.
[15]	冯英连,张磊,王铁梅,林梓桐,刘澍,黄晓峰. 3例颌骨角化型成釉细胞瘤:病例报道及影像学特征分析[J]. 口腔医学研究, 2018, 34(12): 1368-1372.