A Clinical Study of cysts on Mandible

하악골에 발생한 낭종에 관한 임상적 연구

Cystic lesions of the mandible are fairly common and usually a presumptive diagnosis is made readily, more often on the basis of roentgenographic appearance than by any other means. Occasionally, however, it is easy to fall into errors of diagnosis which may affect one's choice of treatment. The diagnosis in these situations are usually resolved by the histopathologic examination of material obtained by surgical exploration. The present discussion to the lesions which can be most easily confused in the roentgenographic interpretation, that is, the traumatic bone cyst, the dentigerous cyst, the radicular cyst. These lesions often grow to considerable size before they cause any subjective or objective symptoms. Less frequently, perhaps, the patient presents himself with the complaint of enlargement of the affected part, a discharge, or pain. On rare occasions the first sign is fracture through the cyst cavity. In any case, an adequate roentgenographic survey by means of extraoral films is essential. This is the primary means of diagnosis. The three lesions in mandible, reported here, resembled each other roentgenographically in that they were osteolytic lesions. The follicular and radicular cysts usually have a smooth periphery and may be surrounded by a white line. The follicular cyst, slow-growing lesions, is usually associated with an unerupted tooth. The radicular cyst, the most common type of the odontogenic cyst, is always associated with a nonvital tooth, or it may persist as a "residual" radicular cyst after the causative tooth has been extracted. The traumatic bone cyst can often be differentiated from the first two in that the periphery is less definite and is irregular. It is thought that because it does not occur in older people, the lesion is self-limiting and heals spontaneously if left alone.