線維性骨疾患のX線画像形態学的考察

―根尖部領域―

抄録

Fibro-osseous lesions appearing on periapical region had especially the term ‘fibro-osseous lesions of periodontal ligament origin’, and so it should be regarded that peculiar metamorphosing or any lesions occurred on the region. Clinical and radiographic features were very important and essential for the diagnosis of the lesions, because pathological features were obviously poor in determinant contents. Changing the old way of thinking was necessary, which attaching too much importance to pathological features. And the morphological consideration leaned toward radiographic features would be finding new or true natures. For the purpose of morphological analysis by radiographic features, it should have been necessary to define a certain standard to expressions in irresponsible use. This study used radiographic features under original standards. In this study, these lesions included several entities, as periapical cemental dysplasia, florid osseous dysplasia, sclerotic cemental mass, etc. Radiographically, these were defined that a small-oval radiopaque area with radiolucent rim surrounding itself and separating from marginal bone. This category was termed ‘Sclerotic mass’ (SM) and analyzed morphologically. At this time, another two categories were added to this study. The one termed ‘EO’ was done as a different lesion, which was given a radiographic definition to entities called enostosis and osteosclerosis, etc. The other one termed ‘SBC’ was done as a related lesion, which was given a radiographic definition to entities called simple bone cyst or traumatic bone cyst, etc. A number of each was as follows; SM was 321 cases (1138 lesions), EO was 232 cases (276 lesions) and SBC was 121 cases (135 lesions).
Fibro-osseous lesions in periapical region without the term cementoblastoma were understanded that which should be termed to metamorphosing conditions of SM with passing time. Though these several entities were termed to calcified areas, the true nature was in radiolucent rim and the making empties in its inside, along with growth. The calcification was merely repaired inside of the radiolucent rim. SM was showed a multiplicative and autonomical proliferation in spite of hamartomatous of pseudotumorous natures. EO and SBC had no tumorous character and no ability of self-growing and self-calcifying. Although each of SM, EO and SBC appeared differently, it was recongnized that all of them should be reparative products and have many similar natures as a result of this study. Before discovering as SM, EO or SBC, the unknown and previous lesion should probably been existing in primary sites. If the lesion would be present like this, the supposed lesion by similar and common natures would be any multiplicative and autonomical lesion, but it's structure would have the end of growth and make an empty of material in center.
This lesion was termed “FOL-X”, three different reparations of its would be termed as SM, EO and SBC. And so that it would be suggested that SM would be a reparative product of periodontal ligament origin to only an empty area in center. EO would be a reparative product of bone origin after getting the end of growth. SBC would be an empty state without reparation, and would be repaired slowly and atrophically by homeostatic function, as time goes on.