Odontogenic tumours in a Chilean population: a retrospective study of 544 cases based on 2022 WHO classification

Background: Odontogenic tumours are infrequent lesions. Studies on the frequency of odontogenic tumours from Latin America are scarce. This work aimed to determine the relative frequency of odontogenic tumours in a Chilean population using the 2022 World Health Organization classification. Material and Methods: This is a case series retrospective study. We reviewed 35,530 samples from 1975 to 2022 from the Oral Pathology Referral Institute and the Pathological Anatomy Service, Faculty of Dentistry, University of Chile. We utilized the 2022 World Health Organization classification for histological typification. Results: According to 2022 World Health Organization classification, 544 odontogenic tumours were confirmed. The most frequent odontogenic tumours were: odontoma (n=241; 44.3%), ameloblastoma (n=109; 20.0%) and cemento-ossifying fibroma (n=71; 13.1%). Benign odontogenic tumours corresponded to 538 cases (98.9%) and malignant tumours were only six cases (1.1%). Conclusions: In our population, odontoma was the most frequent odontogenic tumour followed by ameloblastoma and cemento-ossifying fibroma. Malignant odontogenic tumours were very rare. The results of this study are similar to reports from America, but there are some differences concerning the data from Africa and Asia. (AU)

¿Cuál es su diagnóstico? / What is your diagnosis?

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Marsupialization facilitates movement of the cystic lesion-associated deeply impacted mandibular third molar in spite of its mature roots

Background: The odontogenic cystic lesions happened in the angle and ramus region are frequently associated with impacted mandibular third molars. The treatment plan was difficult to work out for the huge cystic lesions with deeply impacted third molars, since the enucleation with simultaneously removing the deeply impacted teeth may cause serious complications. Therefore, the marsupialization of the cystic lesions followed by enucleation with tooth removal has also been advocated. The aim of this study was to explore the movement of cystic lesion associated deeply impacted mandibular third molars (IMTM) after marsupialization. Material and Methods: Between July 2009 and December 2015, patients who had mandibular cystic lesion associated with IMTM and underwent marsupialization followed by enucleation with tooth extraction were included in our retrospective study. The clinical and pathological data was collected. The distance and direction of movement of the IMTM after marsupialization was measured on panoramic radiograph and computed tomography. Results: Four male and six female patients whose ages ranged from 14 years to 67 years were enrolled in this study. Among the all impacted molars, there were 3 cases with mature roots. After marsupialization, all the cystic lesions shrunk and all impacted teeth moved toward the bony windows, and the distance of tooth movement were from 8.3mm to 12.1mm. The complications included swelling and pain, while no numbness of the ipsilateral lower lip was happened. Conclusions: Marsupialization can promote the movement of impacted teeth with or without mature roots, and may be an optimal treatment approach for the huge posterior mandibular cystic lesions with deeply impacted third molar (AU)

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Ameloblastoma desmoplásico con predominio quístico: presentación de un caso clínico / Desmoplastic ameloblastoma with cystic predominance: presentation of a clinical case

El ameloblastoma es una neoplasia odontogénica que muestra un comportamiento agresivo local. Algunas variantes como la uniquística y la desmoplásica tienen un mejor pronóstico que la sólida/multiquística. Presentamos un caso en un varón de 76 años con una lesión radiolúcida interradicular mandibular de apariencia quística, la cual se enucleó quirúrgicamente. Histológicamente correspondió a una lesión desmoplásica con una amplia zona quística que fue diagnosticada como ameloblastoma desmoplásico con predominio quístico. Trascurridos 30 meses no se evidencia recidiva. En este artículo se discuten los principales aspectos clinicopatológicos de estas entidades (AU)

Ameloblastoma is an odontogenic neoplasm with locally aggressive behavior. Some variants, like the unicystic or desmoplastic, have a better prognosis than solid/multicystic. The case is presented of a 76 year-old male, who suffered a mandibular interradicular radiolucent lesion of cystic appearance, which was surgically enucleated. Histologically, this was a desmoplastic lesion that exhibited a predominantly cystic area which was diagnosed as a desmoplastic ameloblastoma with cystic predominance. After 30 months of follow-up there are no signs of recurrence. The most important clinical and pathological features of these conditions are also discussed (AU)

Retrospective study of 289 odontogenic tumors in a Brazilian population

BACKGROUND: Odontogenic tumors (OTs) are considered important among oral lesions because of their clinicopathological heterogeneity, and variable biological behavior. This paper aims to determine the frequency and distribution of OTs, over a period of 10 years, at a public university in Northeastern Brazil and compare this data with previous reports. MATERIAL AND METHODS: We reviewed all cases of OTs from oral pathology laboratory of University of Pernambuco (UPE), from 2004 to 2014. Diagnoses were re-evaluated and the tumors were classified according to the latest (2005) World Health Organization Classification of Tumors. In addition, we searched in the English-language literature retrospective studies on OTs that used the same classification. RESULTS: Within the total of 6028 oral biopsies, 289 (4.79%) were OTs. Of these, 287 (99.3%) were benign and 2 (0.7%) were malignant. The overall incidence was 31.1/million. Mandible-maxilla ratio was 2.5:1 and mean age 35 years. Keratocystic odontogenic tumor (KCOT) (34.6%) was the most frequent lesion, followed by ameloblastoma (AMB) (32.9%) and odontoma (ODO) (11.4%). CONCLUSIONS: OTs are uncommon neoplasms with geographic variation. Our clinicopathological features are according to literature. In the present study, KCOT was the most frequent one, showing that the new classification of OTs altered the distribution of these lesions and possibly made KCOT the most common OT observed in diagnostic services worldwide

Soft tissue recurrent ameloblastomas also show some malignant features: a clinicopathological study of a 15-year database

BACKGROUND: To investigate the clinicopathological features of six cases of soft tissue recurrent ameloblastoma and explore the role of increased aggressive biological behavior in the recurrences and treatment of this type of ameloblastomas. MATERIAL AND METHODS: In this study, we retrospectively reviewed recurrent ameloblastomas during a 15-year period; six cases were diagnosed as soft tissue recurrent ameloblastoma. The clinical, radiographic, cytological and immunohistochemical records of these six cases were investigated and analyzed. RESULTS: All the six soft tissue recurrent ameloblastomas occurred after radical bone resection, and were located in the adjacent soft tissues around the osteotomy regions. In Case 4, the patient developed pulmonary metastasis, extensive skull-base infiltration and cytological malignancy after multiple recurrences and malignant transformation was diagnosed. In the other five cases, although there were no cytological signs are sufficient to justify an ameloblastoma as malignant, some malignant features were observed. In Case 1, the tumor showed moderate atypical hyperplasia and the Ki-67 staining percentage was 40% positive, which are strongly suggestive of potential malignance. In Case 5, the patient developed a second soft tissue recurrence in the parapharyngeal region and later died of tumor-related complications. All the remaining three patients showed cytology atypia of varying degrees and high expression of PCNA or Ki-67, which confirmed active cell proliferation. CONCLUSIONS: Increased aggressiveness is an important factor of soft tissue recurrence. An intraoperative rapid pathological examination and more radical treatment are suggested for these cases

Enucleación de odontoma compuesto maxilar con regeneración ósea guiada / Compound maxillary odontoma enucleation with guided bone regeneration

Los odontomas son tumores odontogénicos benignos de los maxilares, asociados con frecuencia a retención dentaria, suelen tener un comportamiento indolente, diagnosticándose en radiografías de rutina. El defecto óseo como consecuencia de la osteotomía durante la enucleación del tumor, es una de las principales secuelas que el clínico debe tener presente por la afección no sólo al tejido duro sino también al tejido suave circundante, por esta razón, se han sugerido diferentes materiales para regenerar el tejido óseo perdido. Se reporta caso de paciente masculino de 33 años de edad que asistió a consulta manifestando insatisfacción estética por persistencia de órgano temporal 51 causado por la presencia de un odontoma compuesto, cuyo diagnóstico se corroboró clínica e histológicamente. El defecto óseo residual a la enucleación de dicho tumor se rellenó con hidroxiapatita no reabsorbible, para su posterior restauración definitiva. En el control postoperatorio, se observó resultados estéticos y funcionales satisfactorios (AU)

Odontomas are the most common maxillary beningn odontogenic tumours, who often causing dental retention, most odontomas are asymptomatic and are discovered during routine radiographic investigations. Furthermore, one of the most severe effect that the clinician must take into account is the large bone loss after enucleation of the tumor, affecting not only bone tissue, but also the surrounding soft tissue, however, many materials have been suggested for filled these types of defects bone. We report a case of a 33-year-old men who express aesthetic disagreement due to persistence of temporary tooth 51 caused by the presence of a compound odontoma, whose diagnosis was confirmed clinical and histologically. The residual bone defect after enucleation of the tumor was filled with non-resorbable hydroxyapatite, for subsequent final restoration. In the postoperative control was observed satisfactory aesthetic and functional results (AU)

Fibroma ameloblástico asociado a un odontoma compuesto. La importancia del estudio histopatológico / Ameloblastic fibroma associated with a compound odontoma. Importance of the histopathological study

El fibroma ameloblástico es un tumor odontogénico mixto benigno de rara aparición, que constituye el 2% de todos los tumores odontogénicos, es de crecimiento lento, más común en niños y adultos jóvenes, compuesto por tejido conjuntivo fibroso embrionario y epitelio odontogénico primitivo, se caracteriza por la proliferación de tejido epitelial y mesenquimático. Aparece con más frecuencia en la mandíbula en zona de molares y premolares de pacientes jóvenes sin predilección de sexo, asociándose a veces a un diente incluido. El presente artículo tiene como objetivo describir un caso clínico de un paciente en la segunda década de vida, con aparente anodoncia en el maxilar superior, que se encontraba asintomático y en el cual fue diagnosticado fibroma ameloblástico en maxilar superior, zona de incisivos anteriores, lado izquierdo, se realiza una breve revisión de la literatura y diagnósticos diferenciales, se analizan sus características clínicas e histológicas y la actitud terapéutica a tomar. El tratamiento quirúrgico conservador con extirpación seguida de curetaje parece ser la opción terapéutica más adecuada, y teniendo presente que el porcentaje de recidiva es del 18,3% principalmente debido a escisión incompleta de la lesión, se deben realizar controles radiográficos postoperatorios 6 meses después y cada año por los siguientes 5 años (AU)

The ameloblastic fibroma is a benign mixed, rare odontogenic tumour, which accounts for 2% of all odontogenic tumours. It is slow growing, and more common in children and young adults. It is composed of embryonic fibrous connective tissue and early odontogenic epithelium, and characterised by the proliferation of epithelial and mesenchymal tissue. It appears most frequently in the jaw area of molars and premolars of young patients with no sex predilection, and is sometimes associated with an impacted tooth. This article aims to describe a clinical case of a child in the second decade of life, with apparent anodontia in the maxilla, which was asymptomatic and later diagnosed as an ameloblastic fibroma in the left side maxilla incisors area. A brief review of the literature and differential diagnoses was carried out, including an analysis of its clinical and histological features, and the therapeutic approach to take. Conservative surgical excision followed by curettage seems to be the most appropriate treatment option. It should be noted that the recurrence rate is 18.3%, mainly due to incomplete excision of the lesion. Radiographic controls should be performed six months postoperatively, and every year for the following five years (AU)

Fibro-odontoma ameloblástico de la mandíbula / Ameloblastic fibro-odontoma of the jaw

El fibro-odontoma ameloblástico (FOA) es un tumor odontogénico poco frecuente que afecta a personas jóvenes, sin predilección por género y usualmente se localiza en la zona posterior de la mandíbula. Clínicamente el paciente puede presentar retraso en la erupción dentaria acompañado de aumento de volumen indoloro. Radiográficamente es una lesión radiolúcida uni o multilocular de tamaño variable con áreas radiopacas. El tratamiento varía de acuerdo a su tamaño y se debe tener especial cuidado en la decisión de conservar o no los dientes adyacentes, ya que existe la posibilidad de recurrencia de la lesión. Presentamos un caso de FOA de gran tamaño en un paciente de 4 años. Se describen las características específicas, histológicas y clínicas. Se discute en la conducta terapéutica conservadora y la necesidad de control postoperatorio prolongado en el tiempo(AU)

Ameloblastic fibro-odontoma (AFO) is an infrequent odontogenic tumor that affects young people of either sex and is usually located in the posterior mandibular zone. Clinically, the patient might present a delay in dental eruption with a painless increase in volume. Radiographically, it is a uni- or multilocular radiolucent lesion of variable size with radiopaque areas. Treatment varies with tumor size and the decision to conserve the adjacent teeth must be weighed carefully due to the possibility of recurrence. The case of a large AFO in a 4-year-old patient is reported. The specific histological and clinical characteristics are described and the conservative therapy and need for long-term postoperative follow-up are discussed(AU)

Inclusión de un canino por la presencia de un supernumerario y un odontoma complejo / Impaction of a canine due to the presence of a supernumerary tooth and a complex odontoma

La retención dentaria se define como la detención total o parcial de la erupción de un diente dentro del intervalo de tiempo esperado en relación con la edad del paciente. Incluye tanto los dientes en proceso de erupción como los impactados. La segunda retención más frecuente es la de los caninos, tras los terceros molares inferiores, se localizan en un 85% en el maxilar, un 15%en mandíbula y es más frecuente en el sexo femenino. El diagnóstico de los dientes retenidos, delos dientes supernumerarios y de los tumores odontogénicos, es radiológico, suele realizarse de forma casual en controles rutinarios, o como prueba complementaria ante alteraciones de la erupción, alteraciones intraorales o signos y síntomas de inclusión dentaria. Se presenta un caso clínico con una inclusión del 33 asociado a un supernumerario ya un odontoma. Paciente varón de trece (..) (AU)

Tooth retention is defined as the total or partial stoppage of the eruption of a tooth within the interval of time expected in relation to the patient's age. It includes the teeth in the process of eruption as well as the impacted teeth. The second most frequent retention is that of the canines, following the lower third molars, 85% of which are located in the maxilla, 15% in the mandible and they are more frequent in females. The diagnosis of tooth retention, of supernumerary teeth and of the odontogenic tumours is radiological, usually found by chance in routine checkups, or as a complementary test in the event of disorders in the eruption, intraoral alterations or signs or symptoms of dental impaction. A clinical case is presented with the impaction of the 33 associated to a supernumerary tooth and to an odontoma. Male patient of (..) (AU)

Comparison of the value of PCNA and Ki-67 as markers of cell proliferation in ameloblastic tumors

Objectives: The aim of this study was to compare among PCNA and Ki-67 as the most reliable immunohistochemical marker for evaluating cell proliferation in ameloblastic tumors. Study design: Observational, retrospective, and descriptive study of a large series of ameloblastic tumors, composed of 161 ameloblastomas and four ameloblastic carcinomas, to determine and compare PCNA and Ki-67 expression using immunohistochemistry techniques. Results: When analyzing Ki-67 positivity, the desmoplastic ameloblastoma demonstrated a significantly lower proliferation rate (1.9%) compared with the solid/multicystic and unicystic ameloblastomas and ameloblastic carcinomas (p<0.05), whereas the ameloblastic carcinomas displayed a significantly higher rate compared with all of the other ameloblastomas (48.7%) (p<0.05). When analyzing cell proliferation with PCNA, we found significant differences only between the ameloblastic carcinomas (93.3%) and the desmoplastic ameloblastomas (p<0.05). When differences between the immunopositivity for PCNA and Ki-67 were compared, the percentages were higher for PCNA in all types of ameloblastomas and ameloblastic carcinomas. In all cases, the percentages were greater than 80%, whereas the immunopositivity for Ki-67 was significantly lower; for example, the ameloblastic carcinoma expressed the highest positivity and only reached 48.7%, compared to 93.3% when we used PCNA. Conclusions: In the present study, when we used the proliferation cell marker Ki-67, the percentages of positivity were more specific and varied among the different types of ameloblastomas, suggesting that Ki-67 is a more specific marker for the proliferation of ameloblastic tumor cells (AU)

Odontomas complejos / Complex Odontomas

Introducción: Los odontomas son uno de los tumores odontogénicos más frecuentes. Su etiología es desconocida, aunque se han implicado numerosos factores como traumatismos, infecciones y mutaciones genéticas entre otros. El diagnóstico diferencial debe establecerse con el fibroma amelobástico, el fibroodontoma ameloblástico y el odontoameloblastoma, siendo el tratamiento de elección de estos tumores la enucleación quirúrgica. El objetivo de este artículo es presentar el caso clínico de un paciente con un odontoma complejo mandibular, así como los resultados de la revisión bibliográfica hecha al respecto. Caso clínico: Se expone el caso de un paciente varón, que es remitido a nuestras consultas por el hallazgo casual de una lesión ósea mandibular derecha, radiopaca, amorfa, de 2 cm de diámetro, en relación con el cordal 48 incluido y sugerente de odontoma complejo, sin sintomatología dolorosa niinflamatoria acompañante. Tras un adecuado estudio radiológico y ante el diagnóstico de presunción de odontoma complejo, se procede a su extirpación quirúrgica y posterior análisis anatomopatológico para su diagnóstico de confirmación. Conclusiones: Los odontomas se clasifican en compuestos y complejos, siendo los primeros los más frecuentes. Su sintomatología es escasa o nula, por lo que su hallazgo es casual en la mayoría de las ocasiones. El tratamiento de elección es quirúrgico, con un pronóstico favorable y escasas recidivas (AU)

Introduction: The odontomas are one of the most frequent odontogenic tumours. Their etiology is unknown, although numerous factors have been implicated, such as traumatisms, infections and genetic mutations, among others. The differential diagnosis must be established with ameloblastic fibroma, ameloblastic fibroodontoma and odontoameloblastoma, with surgical enucleation being the treatment of choice of these tumours. The objective of this article is to present the clinical case of a patient with a complex mandibular odontoma, as well as the results of the bibliographical review made in this regards. Clinical case: The case is described of a male patient, referred to our offices because of the casual finding of a right mandibular bone lesion ,radiopaque, amorphous, of 2 cm in diameter, in relation to the included wisdom tooth 48 and suggesting complex odontoma, without painful symptoms or accompanying inflammation. After the appropriate radiological analysis and in view of the presumption diagnosis of complex odontoma, it was surgically removed and subsequent anatomopathological analysis was conducted for the confirmation of the diagnosis Conclusions: Odontomas are classified as compound or complex, with the former being the most frequent. Their symptoms are scarce or nil, for which their finding is casual in the majority of the occasions. The treatment of choice is surgery, with a favourable prognosis and few recurrences (AU)

Odontoma compuesto. Plan de tratamiento / Compound odontoma. Treatment Plan

Un odontoma compuesto es un hamartoma de origen odontogénico relativamente frecuente. Puede bloquear la erupción de los dientes permanentes dando lugar a tramos edéntulos que en ocasiones, suponen un reto en cuanto a la rehabilitación protésica. Se presenta el caso de una mujer, árabe, de treinta y tres años, con ausencia del incisivo central superior izquierdo y compromiso del espacio protésico. Que precisaba resultados estéticos en el sector antero superior. Para completar el diagnóstico se realizó una radiografía periapical que reveló una imagen radioopaca a nivel del 21 compatible con un odontoma compuesto y la inclusión del incisivo central superior permanente. Se inició el tratamiento con una primera fase (..) (AU)

A compound odontoma is a relatively common hamartoma of odontogenic origin. It can block the eruption of permanent teeth causing edentulous areas that can pose a challenge for prostheticre habilitation. The case of an thirty-three year old Arab woman is presented here, with absent upper left centralincisor and compromised prosthetic space, requiring esthetic results in the upper anterior sector. To complete the diagnosis a periapical x-ray was taken revealing a radio-opaque image at the level of site 21 compatible with a compound odontoma, and the inclusion of the permanent upper central (..) (AU)

Investigation of interleukin-1 alpha and interleukin-6 expressionand interleukin-1 alpha gene polymorphism in keratocysticodontogenic tumors and ameloblastomas

Objective: In jawbones, ameloblastomas and odontogenic keratocysts share many clinical features in commonsuch as aggressiveness, high recurrence rates and radical management options. Understanding the pathogenesisand biological aspects of these tumors would improve the success of diagnose and treatment procedures. Theaim of this study was to exhibit the reasons of high recurrence rates and growth potentials of ameloblastomas andkeratocystic odontogenic tumours by investigating the expression of IL-1α and IL-6 and IL-1α -889 gene polymorphism.IL-1α and IL-6 are shown as very effective tissue degrading factors in bone remodelling.Study Design: This study included 25 cases of ameloblastomas, 41 cases of keratocystic odontogenic tumors (parakeratinizedodontogenic keratocysts) and 8 cases of orthokeratinized odontogenic keratocysts. All histologicalslides were stained immunohistochemically to show the expression of IL-1α and IL-6. Restriction fragment lengthanalysis was used to investigate the cytokine gene polymorphism.Results and Conclusions: The higher expression rates of IL-1α and IL-6 were associated with tumor size in ameloblastomasand with cyst wall thickness in keratocystic odontogenic tumors. This finding suggested us that thecytokines IL-1α and IL-6 play a role on aggressive behaviour of ameloblastomas and keratocystic odontogenictumors by making easy bone resorption. In addition, IL-1α (-889) T polymorphism was found consistent withincreased IL-1α expression but not seem as a risk factor on the development of these tumors (AU)

Analysis of different type of transmigrant mandibular teeth

Objective: Until recently, most reports about transmigration have documented that the canine is the only toothwhich can migrate to the opposite side of the arch. The goal of the study was to define the transmigration of differenttypes of teeth in people in various regions of Turkey.Study Design: A total of 112,873 panoramic radiographic files from seven different Turkish cities were inspected.The following data were evaluated according to age, gender, number of transmigrant teeth, localization, eruptionstatus, side, unilaterally or bilaterally and associated pathology or dental abnormalities.Results: Of the 112,873 radiographs included in the study, 90 were seen to present as transmigrant in 87 patients,representing 0.079% of the sample. There were only two (0.0017 %) transmigrant lateral (TML) teeth and onlythree (0.0026%) transmigrant premolar (TMP) teeth encountered. The mean age at the time that the transmigrantmandibular teeth were identified was 29.9 years, with a range from 10 to 66 years. Out of the 87 cases, 51 werefemale and 36 were male, with a male:female ratio of 1:1.41. Transmigrants were more commonly seen unilaterally(96.5%). The most frequent associated pathology was odontoma.Conclusions: Because early detection is vital to prevent complications and ensure more successful treatment, theseextensive studies are crucial. In this extensive study, we indicated cases of transmigration of premolar and lateralteeth as a variant. Demographic variables and properties of all transmigrants (TM) were also presented (AU)

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Odontoma serie de casos. Revisión de literatura / Odontoma case series. Review of literature

El odontoma es el tumor odontogénico más frecuente en cavidad oral, compuesto por una mezcla de células odontogénicas formando dentina y esmalte, presenta células y tejidos normales pero de estructura defectuosa, estos tejidos se encuentran en el área del cuerpo donde se presenta su crecimiento, al examen radiográfico se puede presentar imágenes radiopacas como un gran número de dientes rudimentarios llamados dentículos, en este caso se conoce como odontoma compuesto o presentarse imagen radiopaca como conglomeraciones amorfas, recibiendo el nombre de odontoma complejo. Su etiología se le relaciona con restos paradentales de Malassez, procesos inflamatorios, traumatismos, se le asocia en algunos casos con el quiste odontogénico calcificante, son asintomáticos, producen retención dentaria. El tratamiento es quirúrgico y su recurrencia es baja. Se reporta serie de casos que acudieron al servicio de estomatología y cirugía oral de la Universidad de Cartagena con impresión diagnostica de odontoma, se realizaron los procedimientos quirúrgicos confirmándolos diagnósticos con los reportes histopatológicos (AU)

Odontoma is the most frequent odontogenic tumor in oral cavity, comprising a mixture of odontogenic cellsforming dentin and enamel. It shows cells and normal tissues but in abnormal structure. These tissues are located in the area of the body where it presents its growth. Under radiographic examination may be radiopaque images as a large number of rudimentary teeth called denticles, in this case is known as compound odontomaor presented as conglomerates amorphous radiopaque image, receiving the name of complex odontoma. Its etiology is related to remnants of Malassez paradontals, inflammatory processes. Trauma is sometimes associated with calcifying odontogenic cyst. Generally are asymptomatic, produce tooth retention. Treatment is surgical and recurrence is low. Is reported in the present paper a number of cases that went to the service of dentistry and oral surgery at the University of Cartagena with presumptive diagnosis of odontoma. Surgical procedures were performed to confirm the diagnosis with histopathological analysis (AU)

Fibroma odontogénico central, tipo WHO: reporte de un caso y revisión de la literatura / Central odontogenic fibroma, WHO type: a case report and literature review

El fibroma odontogénico central es una neoplasia benigna muy poco frecuente. Clásicamente se ha dividido en dos variantes histológicas: un tipo pobre en epitelio y otro tipo rico en epitelio con focos de material calcificado. En la mayoría de los casos muestra un crecimiento lento y progresivo con o sin sintomatología. Radiográficamente es habitual observar una imagen radiolúcida y unilocular que en raras ocasiones exhibe radiolucidez mixta. El tratamiento indicado en todos los casos es la enucleación del tumor. Se reporta el caso de una mujer de 36 años de edad, sin antecedentes mórbidos, con una lesión asintomática de radiolucidez mixta, expansiva de ambas corticales óseas, en la zona del cuerpo y ángulo mandibular izquierdo, asociada a un tercer molar incluido. Basándose en el estudio histopatológico inicial, se diagnosticó como fibroma odontogénico, y con el posterior tratamiento definitivo de la lesión, se determinó la subvariedad tipo OMS. La paciente no ha tenido recidiva en 16 meses de seguimiento(AU)

The central odontogenic fibroma is a rare benign neoplasm. Classically has been divided into two histological variants, a poor type epithelium and other rich epithelium with foci of calcified material. It shows in most cases, a slow and progressive growing with or without symptoms. Radiographically it is common to observe a radiolucent, unilocular, rarely exhibiting mixed radiolucency. The treatment in all cases is enucleation of the tumor. We report the case of a 36 year old woman, no morbid history, with an asymptomatic lesion of mixed radiolucency, cortical bone expansion in the area of the body and the left mandibular angle associated with a third molar. Based on the initial histopathology it was diagnosed as odontogenic fibroma and subsequent definitive treatment of the injury rate was determined sub manifold WHO. The patient had no recurrence at 16 months of follow-up(AU)

Importance of cone beam computed tomography for diagnosis of calcifyingcystic odontogenic tumor associated to odontoma. Report of a case

The calcifying cystic odontogenic tumour (CCOT) is a rare benign cystic neoplasm not infrequently associatedwith odontoma. This report documents a case of CCOT associated with compound odontoma arising in theanterior maxilla in a 25-year-old woman. Conventional radiographs showed a large calcified mass with poorlyvisualized radiolucent margins. The extent and condition of the internal structure of the CCOT associated withodontoma was able to be determined based on radiographic findings from cone beam computed tomography.This advanced image technique proved to be extremely useful in the radiographic assessment of this particularneoplasm of the jawbones (AU)

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Simultaneous occurence of compound odontoma and arrested root formationas developmental disturbances after maxillofacial trauma: A case report

Traumatic injury to a primary tooth and/or a bone fracture has the potential to damage the underlying permanenttooth germ which may disturb its development. The extent of the malformation depends on the developmentalstage of the permanent tooth and the intensity of the trauma. The presence of infection may be a predictive factorfor these abnormalities. Open surgical procedures can also potentially cause impaction and developmental disturbances.Several developmental alterations such as discolouration, hypoplasia, crown dilaceration, root angulationor dilaceration, sequestration of permanent tooth buds and disturbance in eruption have been reported in permanentteeth after trauma. However, odontoma-like malformations and partial or complete arrest of root formationare rare complications developed after trauma. This article presents a rare case with simultaneous occurrence ofan odontoma-like malformation and complete and partial arrested root formations as the results of maxillofacialtrauma. Almost all pediatric fractures must be managed with closed reduction as much as possible. However, if itis necessary to perform an open reduction, careful attention must be paid during placement of the osteosyntheticplates and screws; and tooth bud development must be followed periodically (AU)

Ameloblastic fibro-odontoma: A case report

Ameloblastic fibro-odontoma (AFO) is a rare, benign, slow-growing odontogenic tumor, generally asymptomaticand more prevalent in children and adolescents. We report a case of AFO in the mandible of an eight-yearoldCaucasian male patient, and review the literature. Intraoral examination revealed a swelling extending fromthe deciduous second molar to the retromolar triangle, covered with normal mucosa. A panoramic radiographshowed a large, well-demarcated radiolucency with radiopaque areas. The provisional diagnosis was of AFO, andso an incisional biopsy was performed. Histologically, the lesion was composed of connective tissue resemblingthe dental papilla, with epithelial strands or islands, as well as denticles and amorphous masses of enamel anddentin consistent with a diagnosis of AFO. Surgical excision and curettage of the lesion were performed. Thepatient has been monitored for eight years and the lesion has not recurred (AU)

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