上顎洞含歯嚢胞—2自験例とその病態に関する文献的考察

Dentigerous Cyst Involving the Maxillary Sinus: Report of Two Cases, and a Review

I．はじめに

　頬部腫脹や眼，歯などの圧迫症状を主徴とする上顎洞の嚢胞性疾患は少なくないが，含歯嚢胞（dentigerous cyst）によるものば稀である。濾胞性歯嚢胞（fbllicular dental cyst）とも呼ばれているが，歯牙濾胞（歯嚢）の意味が発育途上の歯牙を取り囲む結合組織の部分をさし，含歯嚢胞が発生学的には歯牙の硬組織が完成した後に何らかの原因によってエナメル上皮の中から発生するものであることを考えると^1），濾胞性歯嚢胞と呼ぶのは妥当ではなく，含歯嚢胞といった方がよいように思われる。

　我々は，2例の上顎洞含歯嚢胞を経験したので，症例を報告するとともに，含歯嚢胞の臨床像と発生機転について考えてみた。

　Two cases of large dentigerous cyst involving the maxillary sinus were reported and discussion about clinical features and pathogenesis was also made. The first, a 29-year-old man, showed the half-erupted third molar within the maxillary sinus. The posterior lateral bony wall of the sinus was destroyed by pressure of the growing cyst. The cyst of the second case, an 8-year-old boy, was associated with an impacted canine tooth. The original small maxillary sinus with thin bony wall located behind the cyst. Histopathological examinations showed both of them to be dentigerous cyst. Dentigerous cyst appeared to be a sequel to impeded eruption or inflammation of the surrounding tissue.