目的:描述β-磷酸三钙(TCP)治疗马下颌动脉瘤性骨囊肿(ABCs)的临床、影像学特点及手术治疗。
方法:3匹马(病例1、2和3)和1匹小马(病例4)经组织学证实为ABC。
方法:所有病例均为下颌骨肿胀,邻近皮肤完整。病例1至3的身体状况评分为3/5,病例4的身体状况评分为2/5,并在咀嚼过程中显示出滴注,在口试中,大的齿间空间和松散的元素相邻的肿胀。所有病例均进行X线摄影或CT检查。在第1、3和4例中,可以看到对相邻皮质和牙齿有肿块影响的扩张性纵隔囊性占位性病变,而没有致密的骨破坏。病例2显示异质溶骨性肿块,多灶性皮质溶解和中断。病例4有严重的乳牙异常和恒牙前体。对ABCs进行手术治疗,仅填充TCP(病例3)或与自体骨髓结合使用(病例1、2和4)。
结果:病例1至3显示ABC大小随着不透明度/衰减增加而无影响地减小。在病例4中,发生手术部位感染。去除TCP残留物后,ABC治疗得令人满意,但剩余的牙齿异常需要饮食调整以维持可接受的身体状况评分.
结论:用TCP治疗ABCs具有良好的预后和良好的长期预后。在年轻的标本中,对邻近牙齿发育和萌出的膨胀效应可以影响和决定患病牙齿象限的最终功能。
To describe clinical and imaging features and surgical treatment of equine mandibular aneurysmal bone cysts (ABCs) with β-tricalcium phosphate (TCP).
3 horses (cases 1, 2, and 3) and 1 pony (
case 4) with histologically confirmed ABC.
All cases had mandibular swelling with intact adjacent skin. Cases 1 to 3 had a body condition score of 3/5 and
case 4 had 2/5 and showed quidding during mastication and, at oral examination, large interdental spaces and loose elements adjacent to the swelling. Radiography or CT was performed in all cases. In cases 1, 3, and 4, an expansile septate cystic space-occupying lesion with mass effect on the adjacent cortices and teeth was seen without compact bone destruction.
Case 2 showed a heterogeneous osteolytic mass with multifocal cortical lysis and interruption.
Case 4 had severe dental abnormalities of deciduous and precursors of permanent teeth. ABCs were surgically treated and filled with only TCP (case 3) or in combination with autologous bone marrow (cases 1, 2, and 4).
Cases 1 through 3 showed an uneventful reduction in ABC size with increased opacity/attenuation. In
case 4, a surgical site infection occurred. After removal of TCP remnants, the ABC healed satisfactorily, but remaining dental abnormalities necessitated dietary adjustments to maintain an acceptable body condition score.
Treatment of ABCs with TCP had a favorable outcome and good long-term prognosis. In young specimens, the expansile effect on the development and eruption of neighboring teeth can influence and determine final functionality of the diseased dental quadrant.