Abstract：
OBJECTIVE: The purpose of this mixed-case study is to explore the incidence of pulp necrosis of vital teeth after surgical treatment of adjacent lesions of the jaws.
METHODS: The records of 341 biopsies submitted to the institute\'s histopathology laboratory were reviewed to include cases that met the inclusion criteria. About 84 biopsies collected from patients during surgical enucleation of lesions in proximity to healthy vital teeth were included of which 22 patients were recalled. Adjacent teeth were examined clinically and radiographically to assess their pulpal and periapical status after at least 8 months of follow-up.
RESULTS: There were 7 different pathological lesions diagnosed histologically. The follow-up period ranged between 8 and 72 months; 12 cases (54.6%) have developed pulpal necrosis for at least one tooth after surgical enucleation of the lesion. The other 10 cases (45.4%) showed normal responses to sensibility testing for all the teeth adjacent to the lesion. Ten out of the 12 cases (83%) that underwent pulpal necrosis were associated with odontogenic cysts, whereas the remaining 2 were associated with periapical granuloma and fibrous dysplasia.
CONCLUSIONS: Pulp necrosis is high in vital teeth associated with lesions without pulpal involvement. These teeth may benefit from root canal treatment prior to surgical enucleation of the lesion, which may prevent impaired healing or recurrence of infection.
CONCLUSIONS: Careful treatment planning and thorough discussion should take place between the surgeons, endodontists, and patients prior to executing the treatment. The patient should be aware that there is a possibility that they may need root canal treatment as a preventative measure to enhance the chances of healing following the surgical procedures and in case the patients opted not to perform root canal treatment beforehand, close follow-up in the future should take place to monitor the vitality of the teeth in the follow-up visits.
METHODS: The records of 341 biopsies submitted to the institute\'s histopathology laboratory were reviewed to include cases that met the inclusion criteria. About 84 biopsies collected from patients during surgical enucleation of lesions in proximity to healthy vital teeth were included of which 22 patients were recalled. Adjacent teeth were examined clinically and radiographically to assess their pulpal and periapical status after at least 8 months of follow-up.
RESULTS: There were 7 different pathological lesions diagnosed histologically. The follow-up period ranged between 8 and 72 months; 12 cases (54.6%) have developed pulpal necrosis for at least one tooth after surgical enucleation of the lesion. The other 10 cases (45.4%) showed normal responses to sensibility testing for all the teeth adjacent to the lesion. Ten out of the 12 cases (83%) that underwent pulpal necrosis were associated with odontogenic cysts, whereas the remaining 2 were associated with periapical granuloma and fibrous dysplasia.
CONCLUSIONS: Pulp necrosis is high in vital teeth associated with lesions without pulpal involvement. These teeth may benefit from root canal treatment prior to surgical enucleation of the lesion, which may prevent impaired healing or recurrence of infection.
CONCLUSIONS: Careful treatment planning and thorough discussion should take place between the surgeons, endodontists, and patients prior to executing the treatment. The patient should be aware that there is a possibility that they may need root canal treatment as a preventative measure to enhance the chances of healing following the surgical procedures and in case the patients opted not to perform root canal treatment beforehand, close follow-up in the future should take place to monitor the vitality of the teeth in the follow-up visits.
摘要：
目的：这项混合病例研究的目的是探讨手术治疗颌骨相邻病变后活生牙牙髓坏死的发生率。
方法：对提交给该研究所组织病理学实验室的341例活检记录进行审查，以纳入符合纳入标准的病例。包括在手术摘除健康重要牙齿附近的病变期间从患者收集的约84例活检，其中22例被召回。在至少8个月的随访后，对相邻牙齿进行了临床和影像学检查，以评估其牙髓和根尖周状态。
结果：病理诊断为7种不同的病变。随访时间为8至72个月；12例（54.6％）在手术摘除病灶后至少一颗牙齿发生牙髓坏死。其他10例（45.4％）对邻近病变的所有牙齿的敏感性测试均显示正常反应。12例（83％）牙髓坏死病例中有10例与牙源性囊肿有关，而其余2例与根尖周围肉芽肿和纤维发育不良有关。
结论：在没有牙髓受累的病变相关的重要牙齿中牙髓坏死较高。这些牙齿可能会在手术切除病变之前受益于根管治疗，这可能会阻止受损的愈合或感染复发。
结论：应在外科医生之间进行仔细的治疗计划和彻底的讨论，牙髓医生,和患者在执行治疗之前。患者应该意识到，他们可能需要根管治疗作为一种预防措施，以提高手术后愈合的机会，如果患者选择不事先进行根管治疗，未来应进行密切随访，以在随访中监测牙齿的活力。
方法：对提交给该研究所组织病理学实验室的341例活检记录进行审查，以纳入符合纳入标准的病例。包括在手术摘除健康重要牙齿附近的病变期间从患者收集的约84例活检，其中22例被召回。在至少8个月的随访后，对相邻牙齿进行了临床和影像学检查，以评估其牙髓和根尖周状态。
结果：病理诊断为7种不同的病变。随访时间为8至72个月；12例（54.6％）在手术摘除病灶后至少一颗牙齿发生牙髓坏死。其他10例（45.4％）对邻近病变的所有牙齿的敏感性测试均显示正常反应。12例（83％）牙髓坏死病例中有10例与牙源性囊肿有关，而其余2例与根尖周围肉芽肿和纤维发育不良有关。
结论：在没有牙髓受累的病变相关的重要牙齿中牙髓坏死较高。这些牙齿可能会在手术切除病变之前受益于根管治疗，这可能会阻止受损的愈合或感染复发。
结论：应在外科医生之间进行仔细的治疗计划和彻底的讨论，牙髓医生,和患者在执行治疗之前。患者应该意识到，他们可能需要根管治疗作为一种预防措施，以提高手术后愈合的机会，如果患者选择不事先进行根管治疗，未来应进行密切随访，以在随访中监测牙齿的活力。
