Journal Article [症例] 下顎第二大臼歯に発生した歯周嚢胞の1例
A case of paradental cyst in the mandibular second molar region

才藤, 靖弘  ,  伊豫田, 学  ,  笠間, 洋樹  ,  鵜澤, 一弘  ,  丹沢, 秀樹

93 ( 2 )  , pp.47 - 51 , 2017-04-01 , 千葉医学会
[要旨] 歯周嚢胞は歯の歯頸部付近にみられる炎症性の歯原性嚢胞であり,歯周ポケットの炎症過程を経て発生する。上皮性嚢胞が好発する顎骨において稀な疾患で,中でも第三大臼歯以外に発生する例は報告が少ない。症例は12歳男性。近歯科を受診した際に,X線検査にて嚢胞様病変を指摘され当科を紹介され受診した。CT画像上,左側下顎第二大臼歯の頬側に接する単房性,類円形の透過像を認めた。全身麻酔下に嚢胞摘出術を施行した。その際,第二大臼歯は温存した。病理組織学的検査にて高度の炎症性細胞浸潤を伴う嚢胞壁を認めた。臨床所見,X線検査所見および病理組織学的所見から歯周嚢胞と最終診断した。術後1年間経過観察を行ったが,再発所見は認めず経過良好である。
[Summary] A paradental cyst is an inflammatory odontogenic cyst seen on the lateral aspect of the root or near the cervical margin, as a consequence of an inflammatory process in a periodontal pocket. It is a rare epithelial cyst, and is mainly associated with the mandibular third molar. A 12-year-old boy was referred to the Department of Dentistry and Oral Surgery, Japan Labor Health and Safety Organization, Chiba Rosai Hospital, for the evaluation of a cystic lesion in the mandible. Computed tomography revealed a well-defined ellipsoid radiolucency in the buccal aspect of the mandibular left second molar. We enucleated the lesion, without extraction of the second molar, under general anesthesia. A histopathologic examination of the enucleated lesion revealed heavy inflammatory cell infiltration in the cyst walls. The radiographic and histopathologic findings led to a definitive diagnosis of a paradental cyst on the mandibular left second molar. There has been no evidence of recurrence in this case over a one-year follow-up.

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