RESUMO
ABSTRACT Objective: To perform the epidemiological and clinicopathological analyses of odontogenic tumors in Kerman for 20 years. Material and Methods: The present study investigated collected records from pathology departments of the Faculty of Dentistry, Bahonar, and Shafa teaching-medical hospitals for 20 years. Data on odontogenic tumors was recorded based on age, sex, and tumor location in the information forms. The statistical t-test and the Kappa coefficient computer codes were utilized for data analysis. Results: 38 samples of odontogenic tumors were considered in the present study. The mean age of participants was 31.7± 10.3 years. The frequency of tumors was higher in women (63.2%) and in the lower jaw) 78.9%). Among various tumors, ameloblastoma (63.1%) and odontoma (18.4%) were the most common tumors, respectively. The correlation between clinical and histopathologic diagnoses was 71.8% using the kappa coefficient. Conclusion: Ameloblastoma is the most common odontogenic tumor. The incidence of lesions was higher in the mandible, and odontogenic tumors were higher in women. Since the diagnosis of odontogenic tumors is based on radiographic and histologic appearances, clinical physicians and pathologists should collaborate for the definitive diagnosis of the disease.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Ameloblastoma/diagnóstico , Tumores Odontogênicos/diagnóstico , Epidemiologia/estatística & dados numéricos , Traumatismos Mandibulares , Estudos Epidemiológicos , Prontuários Médicos , Estudos Transversais/métodos , Estudos Retrospectivos , Análise de VariânciaRESUMO
RESUMEN El ameloblastoma es un tumor odontogénico benigno, localmente agresivo y recidivante, con predilección por la región posterior de la mandíbula. Se caracteriza por su agresividad local con muy baja tendencia a metastizarse. El objetivo fue reportar el caso clínico de un paciente con ameloblastoma multiquístico derecho, tratado a través de hemimandibulectomía. Se presentó un paciente masculino, de 44 años de edad, que refirió aumento de volumen del lado derecho de la mandíbula desde hacía aproximadamente un año, acompañado también de otros síntomas, atendido en el Servicio de Cirugía Maxilofacial del Hospital Militar Principal/Instituto Superior, en Luanda, Angola. Los estudios imagenológicos incluyeron radiografía panorámica y tomografía axial computarizada. El diagnóstico clínico patológico fue de ameloblastoma multiquístico. Este tipo de tumor requiere de un adecuado diagnóstico sobre la base de la presentación clínica, localización, tamaño, edad y tipo histológico; de ahí la importancia de conocer las características clínicas e imagenológicas, pues el tratamiento conlleva gran dificultad (AU).
ABSTRACT Ameloblastoma is a benign odontogenic tumor, locally aggressive and recidivist with predilection for back of the jaw, characterized by local aggressiveness and low tendency to metastasize. The aim was reporting the clinical case of a patient with right multicystic ameloblastoma treated through hemimandibulectomy. We presented a male patient aged 44 years, who referred a volume increase of the jaw right side for around a year, accompanied also by other symptoms; he attended the Maxillofacial Surgery Service of the Main Military Hospital/High Institute of Luanda, in Angola. The image studies included panoramic radiography and computerized axial tomography the clinical pathological diagnosis was multicystic ameloblastoma. This kind of tumor requires an adequate diagnosis based on the clinical presentation, location, size, age and histological kind, therefore the importance of knowing the clinical and image characteristics, because the treatment is very difficult (AU).
Assuntos
Humanos , Masculino , Adulto , Ameloblastoma/cirurgia , Osteotomia Mandibular/métodos , Biópsia/métodos , Ameloblastoma/complicações , Ameloblastoma/diagnóstico , Doenças Mandibulares/diagnóstico , Tumores Odontogênicos/cirurgia , Tumores Odontogênicos/diagnóstico , Diagnóstico ClínicoRESUMO
Se describen 2 casos clínicos de adolescentes de ambos sexos, quienes presentaron edemas en el lado izquierdo de la mandíbula con reabsorción dental y en la porción anterior del maxilar, respectivamente. La histopatología reveló una variante folicular intraósea del tumor odontogénico adenomatoide. El tratamiento quirúrgico empleado fue una enucleación con resultados satisfactorios.
Two cases reports of adolescents from both sexes are described, they presented edemas in the left side of the maxillary with dental reabsorption and in the anterior portion of the maxillary, respectively. The histopathology revealed an intraosseous folicular variety of the adenomatoid odontogenic tumor. The surgical treatment used was an enucleation with satisfactory results.
Assuntos
Tumores Odontogênicos/cirurgia , Edema , Tumores Odontogênicos/diagnóstico , Tumores Odontogênicos/diagnóstico por imagem , AdolescenteRESUMO
Abstract Objectives: This study approaches the history of reclassifications and redefinitions around the odontogenic keratocyst (OK), as proposed by the World Health Organization (WHO), and aims to understand the impact of those changes on the prevalence and epidemiology of odontogenic tumors (OTs). Methodology: Cases of OTs diagnosed in an Oral Pathology service between January 1996 and December 2016 were reviewed. Demographic data of patients such as age, gender and site of lesions were retrieved from their respective records. Results: Within the studied period, 7,805 microscopic reports were elaborated and 200 (2.56%) of these were diagnosed as OTs. Out of these 200, between 1996 and 2005, prior to the 2005 WHO classification, there were 41 (20.5%) OTs cases, being odontoma the most frequent (23; 56.09%), followed by ameloblastoma (8; 19.51%) and myxoma (03; 7.31%). Between 2006 and 2016, after the previous 2005 WHO classification there were 159 (79.5%) OTs, being odontogenic keratocystic tumor (KCOT) the most frequent (68; 42.76%), followed by odontoma (39; 24.52%) and ameloblastoma (21; 13.20%). Conclusions: As of today, the most recent WHO classification to be followed brings KCOT back to the cyst category, which will impact on the prevalence and epidemiology of OTs; thus, this study was able to identify a considerable increase (287.80%) in the prevalence of OTs when the 2005 WHO classification was utilized. Despite being an important academic exercise, classifying odontogenic lesions and determining whether to place the odontogenic keratocyst in a cyst or tumor category is crucial to establish the correct diagnosis and treatment to follow, whether by oral medicine or oral surgery specialist, or by the general practitioner.
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Organização Mundial da Saúde , Tumores Odontogênicos/classificação , Brasil/epidemiologia , Tumores Odontogênicos/diagnóstico , Tumores Odontogênicos/epidemiologia , PrevalênciaRESUMO
El Fibroma Odontogénico Periférico fue definido por la OMS en el año 2005 como una neoplasia benigna rara constituida por tejido fibroso maduro y una cantidad variable de epitelio odontogénico inactivo. Dada su presentación clínica, localización y baja prevalencia suele ser mal diagnosticado como una lesión reaccional. Se presenta un caso clínico de fibroma odontogénico periférico tratado mediante remoción quirúrgica y se realiza una revisión de la bibliografía respecto a la patología con el propósito de esclarecer algunos aspectos de esta lesión, además de incluirla dentro de los posibles diagnósticos diferenciales de lesiones reaccionales gingivales. El objetivo del siguiente artículo es presentar un caso clínico de FOP tratado mediante remoción quirúrgica y aportar en el diagnóstico diferencial de las lesiones reaccionales gingivales.
Peripheral odontogenic fibroma was described by the World Health Organization (WHO) in 2005, as a rare benign tumor containing mature fibrous connective tissue with a varying amount of inactive odontogenic epithelium. Though its clinical presentation, localization and low prevalence, it tends to be misdiagnosed as a reactive lesion. We present a case report of a Peripheral Odontogenic Fibroma treated by surgical resection and a narrative review of the literature with the purpose of clarifying different aspects of this lesion besides considering it as a possible differential diagnosis of reactive gingival lesions. The purpose of this article is to present a case report of peripheral odontogenic fibroma treated by surgical resection. Also to contribute to the differential diagnosis of gingival reactive lesions.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Neoplasias Gengivais/cirurgia , Neoplasias Gengivais/diagnóstico , Tumores Odontogênicos/cirurgia , Tumores Odontogênicos/diagnóstico , Reabsorção de Dente/etiologia , Neoplasias Gengivais/patologia , Tumores Odontogênicos/patologia , Diagnóstico Diferencial , FibromaRESUMO
Cementoblastoma é um tumor odontogênico benigno incomum de origem mesenquimalque usualmente afeta ossos gnáticos de indivíduos jovens, produzindo dor ou desconforto. Pode ser erroneamente diagnosticado como outras lesões, devido sua variada apresentação clínica era diográfica. Frequentemente o tratamento sugerido é a ressecção tumoral em conjunto como dente associado. Entretanto, abordagem mais conservadora pode ser uma opção em alguns casos assintomáticos e estáveis, como observado neste estudo. Apresentamos oito novos casos e uma breve revisão da literatura a fim de melhor caracterizar o comportamento biológico desta relativamente rara lesão.
Cementoblastoma is an uncommon benign odontogenic tumour of mesenchymal originthat affects the jaws of generally young persons, producing pain or discomfort. It may be mistakenfor several other lesions, due to its varied clinical and radiographic features. The suggestedtreatment is often tumour resection in conjunction with the associated tooth. However, a moreconservative approach could be an option in asymptomatic and stable lesions as seen in thepresent study. Eight new cases and a brief review of the literature are presented here to bettercharacterize the biological behavior of this relatively rare lesion.
Assuntos
Humanos , Masculino , Feminino , Condutas Terapêuticas Homeopáticas/classificação , Condutas Terapêuticas Homeopáticas/normas , Condutas Terapêuticas Homeopáticas/organização & administração , Protocolos Clínicos/normas , Tumores Odontogênicos/complicações , Tumores Odontogênicos/diagnóstico , Tumores Odontogênicos/metabolismoRESUMO
Odontogenic myxomas (OMs) are rare, benign, slow-growing tumors that may arise in the maxilla. They are known to have a female predilection and present as a painless mass commonly in the second or third decade of life, comprising 3-6% of all odontogenic tumors. They show a locally aggressive behavior, are radioresistant tumor and hence the need for early recognition and surgical resection. A high rate of recurrence has also been noted owing to its infiltrative pattern of growth and lack of capsule. Clinical and radiological aspects of maxillary OMs are not conclusive hence it is necessary to have a histopathological exam for the final diagnosis. We present a case of OM involving the maxilla in a 51-year-old female patient. The various histopathological differentials are also discussed.
Assuntos
Feminino , Humanos , Maxila/patologia , Pessoa de Meia-Idade , Mixoma/anatomia & histologia , Mixoma/diagnóstico , Mixoma/epidemiologia , Mixoma/patologia , Tumores Odontogênicos/anatomia & histologia , Tumores Odontogênicos/diagnóstico , Tumores Odontogênicos/epidemiologia , Tumores Odontogênicos/patologiaRESUMO
Ameloblastic fibrodentinoma (AFD), according to the WHO is a neoplasm similar to ameloblastic fibroma, but also showing inductive changes that lead to the formation of dentine. AFD is a very rare odontogenic mixed tumor and only <40 cases have been reported so far. The origin, like other mixed odontogenic tumors is from the odontogenic apparatus. Two schools of thought exist, one to consider it as a variant of ameloblastic fibroodontoma and the other categorize it as a separate entity. An AFD in an 1½-year-old male patient with 12-year follow-up after treatment is presented.
Assuntos
Biópsia , Seguimentos , Humanos , Lactente , Masculino , Odontoma/diagnóstico , Odontoma/patologia , Tumores Odontogênicos/diagnóstico , Tumores Odontogênicos/patologia , Tumores Odontogênicos/cirurgia , Resultado do TratamentoRESUMO
Introdução. O cirurgião-dentista é na maioria das vezes, o responsável pelo diagnóstico e tratamento das lesões ósseas dos maxilares. O diagnóstico é decisivo na conduta terapêutica a ser seguida. Na literatura, análises retrospectivas são vistas com maior frequência, onde foram coletados resultados de exames histopatológicos. Contudo, para algumas lesões, o diagnóstico é clínico e radiográfico, não sendo indicada a realização de biópsia. Objetivo. O objetivo deste estudo foi descrever a prevalência das lesões ósseas dos maxilares, assim como avaliar suas características clínicas e radiográficas. Correlacionar a principal hipótese diagnóstica com o diagnóstico final. Pacientes e Métodos. Estudo com 130 pacientes com lesões ósseas dos maxilares diagnosticadas no Centro de Diagnóstico Oral da Disciplina de Estomatologia Clínica da Faculdade de Odontologia da Universidade de São Paulo (CDO-FOUSP), entre Agosto de 2013 e Outubro de 2014. Os pacientes foram divididos em 4 grupos: 1: Tumores benignos odontogênicos e não odontogênicos. 2: Cistos odontogênicos e não odontogênicos. 3: Tumores malignos. 4: Outras lesões. Análise estatística foi realizada buscando estabelecer informações relevantes quanto aos dados epidemiológicos, clínicos e radiográficos destas lesões. Resultados. A idade média foi de 35,2 anos ±17,86, (variou entre 8 e 77 anos). Dos 130 pacientes, 71 eram mulheres (54,62%) e 87 leucodermas (66,92%). A mandíbula foi mais acometida (71,43%), do que a maxila (28,57%). As características clínicas mais observadas foram: aumento de volume em 60 casos (42,85%), dor em 38 (27,14%) e 16 casos (11,43%) apresentaram drenagem de secreção purulenta. O exame complementar de imagem mais utilizado foi a radiografia panorâmica, 124 exames (88,57%).
Em 47 lesões (33,57%), o diagnóstico foi realizado através do exame clínico, radiográfico e conduta cirúrgica (displasias ósseas, cistos ósseos simples, escleroses ósseas, dentre outras). Lesões com imagens radiolúcidas representaram 89 casos (63,57%), a forma unilocular esteve presente em 114 casos (81,43%) e 101 lesões (72,14%) apresentaram relação com o ápice dental. Dos casos que houve análise histopatológica (93 casos), o cisto periapical foi a lesão mais frequente totalizando 38 casos, 12 cistos dentígeros, 9 odontomas (7 compostos e 2 complexos), 8 TOQ, 6 cistos residuais, 5 ameloblastomas, e outras lesões. Houve 3 casos de tumores malignos, sendo 1 osteossarcoma, 1 carcinoma mucoepidermóide e 1 mieloma múltiplo. O percentual de acerto entre a principal hipótese diagnóstica com o diagnóstico final foi de 76,82%. Conclusões. Lesões ósseas foram frequentes e representaram aproximadamente 30% das primeiras consultas. Lesões com características radiográficas radiolúcidas e uniloculares foram as mais frequentes. Em um terço dos casos, não foi indicado (necessário) o exame histopatológico para a conclusão do diagnóstico. Sendo utilizadas as informações clínicas, radiográficas e abordagem cirúrgica (casos de cisto ósseo simples).
Introduction. The dentist is the main professional responsible for the diagnosis and treatment of bone lesions of the jaws. The diagnosis is crucial to therapeutic decision. In the literature, retrospective analyzes are more frequents, and the data are collected from histopathological exams. However, for some lesions, the diagnosis is clinical and radiographic, and the biopsy is not indicated. Objective. The aim of this study was to describe the prevalence of bone lesions of the jaws, and evaluate its clinical and radiographic features. In addition, the correlation between the main diagnosis and the final diagnosis was performed. Patients and Methods. A study which evaluated a total of 130 patients with bone lesions of the jaws. All cases were diagnosed in Oral Diagnosis Center of the Stomatology Discipline, School of Dentistry, University of São Paulo (CDO-FOUSP), between August 2013 and October 2014. Patients were divided into 4 groups: 1: Benign odontogenic and non odontogenic tumors. 2: Odontogenic and non odontogenic cysts. 3: Malignant tumors. 4: Other lesions. Statistical analysis was performed to establish relevant information on the epidemiological, clinical and radiographic data of these lesions. Results. The mean age of the patients was 35,2 years ± 17.86 (range, 8 to 77 years). Among 130 patients, 71 were women (54.62%) and 87 were Caucasians (66.92%).
The mandible was more affected (71.43%) than the maxilla (28.57%). The most frequent clinical signs were swelling in 60 cases (42.85%), pain in 38 (27.14%) and 16 cases (11.43%) showed purulent drainage. The panoramic radiograph was the most used imaging exam, 124 exams (88.57%). In 47 lesions (33.57%), the diagnosis was done by clinical examination, radiographic and surgical management (bone dysplasia, simple bone cysts, bone sclerosis, and others). Radiolucent lesions accounted for 89 cases (63.57%), the unilocular form was present in 114 cases (81.43%) and 101 lesions (72.14%) were related to the dental apex. A total of 93 cases had histopathological analyses; periapical cyst was the most frequent lesion, representing 38 cases, 12 dentigerous cysts, 9 odontomas (7 compounds and 2 complexes), 8 OKT, 6 residual cysts, 5 ameloblastomas and other lesions. There were 3 malignant tumors, 1 osteosarcoma, 1 mucoepidermoid carcinoma and 1 multiple myeloma. The correlation between the main diagnosis hypotheses with a final diagnosis showed a success rate of 76.82%. Conclusions. Bone lesions were frequent and represented approximately 30% of the first visit patients. Lesions that presented radiolucent and unilocular radiograph pattern were the most frequent. In one third of cases, it was not indicated (necessary) the histopathological examination to conclude the diagnosis. Being used data of clinical, radiographic and surgical approach (cases of simple bone cyst).
Assuntos
Cistos Odontogênicos/complicações , Cistos Odontogênicos/diagnóstico , Cistos não Odontogênicos/diagnóstico , Neoplasias Bucais , Tumores Odontogênicos/complicações , Tumores Odontogênicos/diagnósticoRESUMO
Tumores odontogênicos constituem grupo abrangente de afecções tumorais, sendo ameloblastomas e tumores odontogênicos queratocísticos as lesões benignas de maior frequência, cujas características biológicas são pouco conhecidas. Objetivo do presente estudo foi avaliar o perfil imuno-histoquímico das proteínas pRB e p53 em ameloblastoma e tumor odontogênico queratocístico. Foram avaliadas amostras de material parafinado de 21 casos de ameloblastoma e de 20 casos de tumor odontogênico queratocístico para ensaio de imuno-histoquímica com os anticorpos anti-pRB e anti-p53. A contagem da imuno-marcação foi realizada a partir de fotografias de alta resolução processadas no software ImageJ para quantificação manual em campo de 1000 células. A localização da imuno-marcação para ambos anticorpos foi semelhante, sendo em ameloblastomas predominantemente nas células da periferia e, em tumores odontogênicos queratocísticos, nas camadas suprabasais. Quantitativamente, as porcentagens de células marcadas foram estatisticamente maior nos ameloblastoma para anti-p53 (p=0,01) e maior nos tumores odontogênicos queratocísticos para anti-pRB (p=0,04). Não houve correlação estatística entre a porcentagem de células marcadas para anti-p53 e anti-pRB nos ameloblastomas, porém, esta correlação foi positiva e moderada nos tumores odontogênicos queratocísticos (r=0,537; p=0,018). Nota-se ligeira diferença na quantificação das imuno-marcações para o anti-p53 e anti-pRB. Tais resultados devem ser ponderados pela reduzida casuística, porém, sugerem perfis distintos em mecanismos biológicos determinantes para ambos os tumores.
Odontogenic tumors are a comprehensive group of tumor diseases, being ameloblastomas and keratocystic odontogenic tumors the most frequent benign odontogenic tumors. Their biological characteristics are little unknown. The aim of present study was to evaluate the immunohistochemical profile of pRB and p53 proteins in 21 cases of ameloblastomas and 20 cases of keratocystic odontogenic tumors for anti-pRB and anti-p53 antibodies. The quantification of immunostaining was performed manually with high-resolution photographs processed in the ImageJ software to quantify positive cells in a 1000 cells-field. The location of immunostaining for both antibodies was similar. In ameloblastomas, positive cells are located mainly in the peripheral layers, whereas in keratocystic odontogenic tumors the positive cells are located in the suprabasal layers. Quantitatively, the percentage of labeled cells was statistically higher in ameloblastomas for anti-p53 (p = 0.01) and higher in keratocystic odontogenic tumors for anti-pRB (p = 0.04). There was no statistical correlation between the percentage of labeled cells to anti-p53 and anti-pRB in ameloblastomas, however, its correlation was positive and moderate in keratocystic odontogenic tumors (r = 0.537; p = 0.018). It is possible to identify a slight difference in immuno-quantification for anti-p53 and anti-pRB among these lesions. These results must be pondered by the small sample, however, is suggests a different profile in a preponderant key biological mechanisms for odontogenic tumors.
Assuntos
Ameloblastoma/classificação , Ameloblastoma/complicações , Ameloblastoma/diagnóstico , Tumores Odontogênicos/complicações , Tumores Odontogênicos/diagnósticoRESUMO
Os tumores odontogênicos formam um grupo complexo de lesões, de comportamento clínico variado e encontrado exclusivamente na região bucomaxilofacial. Originam-se a partir das células que normalmente teriam a função de formar o dente, processo esse denominado odontogênese, que tem seu início entre a sexta e a sétima semanas de vida intrauterina. O objetivo deste trabalho foi realizar um estudo clinicopatológico de tumores odontogênicos diagnosticados no Serviço de Patologia Cirúrgica da Faculdade de Oodontologia da Universidade de São Paulo de 1957 a 2012. Foram compilados das fichas de requisição de exames e/ou prontuários dados referentes ao sexo, idade no momento do diagnóstico, cor da pele (branca, negra, ou outras), sintomatologia, tamanho da lesão, duração, localização anatômica, aspectos radiográficos, diagnóstico clínico e histopatológico. Os casos diagnosticados como tumores odontogênicos foram revisados, por um examinador previamente calibrado, com o objetivo de reclassificação das lesões conforme proposição atual da Organização Mundial da Saúde em 2005. Todos os dados obtidos foram inseridos e tabulados no Microsoft Office Excel 2013 e analisados no software BioEstat 5.0. Medidas de frequência central e de dispersão foram obtidas e os resultados apresentados em forma de tabelas e gráficos. Na análise estatística, foi empregado o teste Z de duas proporções com nível de significância de 5%. No período compreendido de 01 de janeiro de 1957 a 31 de dezembro de 2012, foram diagnosticados 2.114 casos de tumores odontogênicos.
Do total de casos diagnosticados, 75 casos foram retirados da análise, pois representavam a mesma lesão em diferentes momentos. Portanto, 2.039 casos de tumores odontogênicos foram incluídos e, após revisão dos casos e reclassificação diagnóstica dos tumores odontogênicos, os 2.039 casos foram agrupados em 16 tipos histológicos diferentes, entre os quais 2.029 (99,51%) eram benignos e 10 (0,49%) malignos. De uma maneira geral, os tumores odontogênicos afetam pacientes na segunda e terceira décadas de vida, sem predileção por sexo, apresentam-se menores do que 1cm de diâmetro e são diagnosticados, em média, 2 anos após seu surgimento. A maioria das lesões acometem a região posterior da mandíbula, com exceção do odontoma e tumor odontogênico adenomatóide, e apresentam aspecto radiográfico radiolúcido inespecífico, o que dificulta um diagnóstico preciso sem a avaliação anatomopatológica.
Odontogenic tumors are a complex group of lesions, varied clinical behavior and found exclusively in the oral and maxillofacial region. Originate from cells that would normally have the function of forming the tooth, a process called odontogenesis, which begins between the sixth and seventh weeks of intrauterine life. The aim of this study was a clinicopathological study of odontogenic tumors diagnosed in Surgical Pathology Service of Oodontologia of the University of São Paulo from 1957 to 2012 were compiled from surveys of request forms and / or records data on gender, age at diagnosis, skin color (white, black, or other), symptoms, lesion size, duration, anatomic location, radiographic findings, clinical and histopathological diagnosis. The cases diagnosed as odontogenic tumors were reviewed by a calibrated examiner, in order to reclassify injuries as current proposition of the World Health Organization in 2005. All data were entered and tabulated in Microsoft Office Excel 2013 and analyzed in software BioEstat 5.0. Central frequency and dispersion measurements were obtained and the results presented in tables and graphs. In the statistical analysis, we used the Z test for similar proportions with 5% significance level. In the period of January 1, 1957 to December 31, 2012 were diagnosed 2,114 cases of odontogenic tumors. Of all diagnosed cases, 75 cases
were removed from the analysis because they represented the same injury at different times. Therefore, 2,039 odontogenic tumors were included and, after review of the cases and diagnostic reclassification of odontogenic tumors, 2,039 cases were grouped into 16 different histological types, including 2 029 (99.51%) were benign and 10 (0, 49%) malignant. In general, the odontogenic tumors affect patients in the second and third decades of life, with no gender preference, are presented less than 1cm in diameter and are diagnosed on average two years after its inception. Most injuries involve the posterior mandible, except for the odontoma and adenomatoid odontogenic tumor, and feature radiolucent radiological findings nonspecific, which hinders accurate diagnosis without pathological assessment.
Assuntos
Ameloblastoma/complicações , Ameloblastoma/diagnóstico , Epidemiologia/estatística & dados numéricos , Neoplasias Bucais/classificação , Neoplasias Bucais/complicações , Neoplasias Bucais/diagnóstico , Odontoma/complicações , Odontoma/diagnóstico , Tumores Odontogênicos/complicações , Tumores Odontogênicos/diagnósticoRESUMO
The keratocystic odontogenic tumor is a benign intraosseous neoplasm derived from remnants of the dental lamina and it occurs with high frequency. Regarding histological characteristics, it has a high recurrence rate which is one of the main therapeutic problems. Also, it presents high local aggressiveness, expressed in cortical expansion, delayed eruption and displacement of teeth, blood vessels and nerves. At present, there are various treatments, being ideal the one which presents the lowest risk of recurrence with low morbidity for the patient. In this review, the main histopathological, clinical and therapeutic aspects of this oral pathology are discussed.
El tumor odontogénico queratoquístico es una neoplasia intraósea benigna que deriva de restos de la lámina dental, y que se presenta con alta frecuencia. Sus características histológicas le confieren una elevada tasa de recidiva, siendo este uno de sus principales problemas terapéuticos. Presenta además una considerable agresividad local, la cual se expresa con la expansión de corticales óseas, retardo en la erupción y desplazamiento de dientes, vasos sanguíneos y nervios. En la actualidad existen diversos tratamientos, siendo el ideal aquel que presente el menor riesgo de recidiva con una baja morbilidad para el paciente. En la presente revisión se discuten los principales aspectos histopatológicos, clínicos y terapéuticos de esta patología oral.
Assuntos
Humanos , Cistos Odontogênicos/diagnóstico , Cistos Odontogênicos/patologia , Tumores Odontogênicos/diagnóstico , Tumores Odontogênicos/patologia , Descompressão Cirúrgica , Diagnóstico Diferencial , Cistos Odontogênicos/cirurgia , Tumores Odontogênicos/cirurgiaAssuntos
Adulto , Feminino , Humanos , Neoplasias do Seio Maxilar/diagnóstico , Cistos Odontogênicos/diagnóstico , Tumores Odontogênicos/diagnóstico , Doenças Raras/diagnóstico , Neoplasias do Seio Maxilar/cirurgia , Cistos Odontogênicos/cirurgia , Tumores Odontogênicos/cirurgia , Doenças Raras/cirurgia , Tomografia Computadorizada por Raios XRESUMO
El Tumor odontogénico queratoquístico es una entidad benigna de prevalencia relativamente alta que surge desde los remanentes de la lámina dental, el cual tiene un potencial comportamiento agresivo y alta recurrencia. Este tiende a crecer lentamente dentro del canal medular en sentido anteroposterior transformándose en una gran lesión sin causar una expansión obvia. Esta revisión describe la clínica, imagenología y tratamientos actuales del Tumor Odontogénico Queratoquístico a propósito de un paciente de sexo masculino 30 años diagnosticado con esta entidad.
Keratocystic Odontogenic tumor is a benign entity with relatively high prevalence that arises from remains of dental lamina. It has a potentially aggressive behaviour, high recurrence and anteroposterior slow growth in the medullar canal, which can become large lesion without obvious expansion. This review describes clinical, imagenological and current treatments of Keratocystic Odontogenic Tumor in 30- year-old male patient diagnosed with this entity.
Assuntos
Humanos , Masculino , Adulto , Neoplasias Mandibulares/cirurgia , Neoplasias Mandibulares/diagnóstico , Cistos Odontogênicos/cirurgia , Cistos Odontogênicos/diagnóstico , Tumores Odontogênicos/cirurgia , Tumores Odontogênicos/diagnóstico , Recidiva Local de NeoplasiaRESUMO
A presente pesquisa objetivou realizar um levantamento epidemiológico retrospectivo do tumor odontogênico queratocístico no Serviço de Patologia Bucal do Curso de Graduação em Odontologia da Universidade de Fortaleza, no período de novembro de 2001 a março de 2011. Os dados foram coletados pela revisão das fichas de requisição de exame histopatológico e seus respectivos laudos, buscando dados relativos à idade, sexo, raça, localização, tipo de biópsia, associação com dentes inclusos, presença de sintomatologia e hipótese diagnóstica no momento da biópsia. Foram coletados 97 casos, consistindo 14,51% dos cistos odontogênicos neste período. O perfil demográfico encontrado foi formado, na maioria, por pacientes do sexo masculino em 50 casos (48,4%), leucodermas 40 (54%), com idade média de 34,3 anos, variando de 9 a 77, acometendo predominantemente a região posterior da mandíbula em 51 (67,1%), sendo assintomáticos em 52 (72,2%) dos casos
This research aimed to perform a retrospective epidemiological study of keratocystic odontogenic tumor at the Department of Oral Pathology of the Graduate Program in Dentistry, of the Universidade de Fortaleza, from November of 2001 to March 2011.Data were collected through review of histopathology test request form and its reports, searching for data regarding: age, gender, race, location, type of biopsy, association with impacted teeth, presence of symptoms and diagnosis hypothesis in case of biopsy. Ninety seven cases were selected, corresponding to 12.9% of odontogenic cysts collected in this period. The demographic profile was found to be composed mostly of male patients in 50(48.4%), Caucasian 40(54%), with a average age of 34.3 years, ranging from 9 to 77 years , affecting mainly the posterior region of the mandible in 51 patients (67.1%) and asymptomatic in other 52 cases (72.2%)
Assuntos
Humanos , Masculino , Feminino , Cistos Odontogênicos/diagnóstico , Cistos Odontogênicos/patologia , Cistos Maxilomandibulares , Queratinas , Tumores Odontogênicos/diagnóstico , Tumores Odontogênicos/patologia , Inquéritos EpidemiológicosRESUMO
This study investigated the viability of the cell block technique as an auxiliary method of diagnosing jawbone lesions. Thirty-three clinically diagnosed jawbone lesions with a cystic appearance were subjected to aspiration. The aspirated material was processed by the cell block technique, and the lesions were biopsied and treated. Cytological findings (cell block) and histopathology analyses (gold standard) were compared by the chi-square test. There were associations between cysts and cholesterol crystal clefts, between keratocystic odontogenic tumors (KOT) and epithelial cells, and between KOT and parakeratin. The occurrence of cholesterol crystal clefts in cell block slides was correlated with cystic lesions, and the parakeratin presence was a KOT indicator. The cell block technique proved to be fast, easy-to-handle, and low-cost, making it an attractive auxiliary method for the preliminary diagnosis of jawbone lesions.
Assuntos
Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Pessoa de Meia-Idade , Adulto Jovem , Cistos Maxilomandibulares/diagnóstico , Tumores Odontogênicos/diagnóstico , Biópsia por Agulha Fina , Citodiagnóstico/métodos , Cistos Maxilomandibulares/patologia , Tumores Odontogênicos/patologia , Inclusão em Parafina , Reprodutibilidade dos TestesRESUMO
INTRODUÇÃO: A busca por novos métodos que auxiliem e simplifiquem de maneira eficaz o diagnóstico de lesões maxilares, cistos e tumores, objetiva beneficiar os pacientes e facilitar a atuação dos profissionais da área de diagnóstico bucal. Além dos dados clínicos, radiográficos e histopatológicos classicamente utilizados nos protocolos de investigação das lesões maxilares, a adaptação de técnicas já consagradas na medicina pode ser de grande valia. A técnica de cell block se propõe a auxiliar nesse processo, pois consiste na análise citológica de materiais, efusões e líquidos, coletados de lesões passíveis de punção aspirativa, como cistos e tumores císticos dos maxilares. OBJETIVO: Demonstrar a aplicabilidade da técnica de cell block para avaliação citológica de material biológico coletado a partir de lesões císticas dos maxilares. RESULTADOS: Das 20 lesões, das quais o conteúdo foi processado pela técnica, a avaliação citológica de cinco casos de tumores odontogênicos ceratocísticos (TOCs) demonstrou a presença predominante de ceratina, sempre com áreas de paraceratina. Nos demais casos (cinco cistos dentígeros, cinco cistos radiculares e cinco cistos residuais) foi observada a presença de hemácias, células inflamatórias e fendas de cristais de colesterol. CONCLUSÃO: A avaliação citológica, a partir da técnica de cell block, foi útil no estabelecimento do diagnóstico diferencial entre TOC e demais lesões estudadas, cistos radicular, residual e dentígero.
INTRODUCTION: The search for new methods that aid and optimize the diagnosis of cystic and tumoral maxillary lesions aims to benefit both patients and professionals from oral diagnosis. In addition to clinical, radiographic and histological findings traditionally used in research protocol for maxillary lesions, the adaptation of widely used medical techniques may be very helpful. The cell block procedure streamlines this process, inasmuch as it consists of cytopathological analysis of materials, liquids and effusions, collected from aspirated lesions such as maxillary cysts and cystic maxillary tumors. OBJECTIVE: To demonstrate the applicability of cell block technique for cytological assessment of biological material collected from cystic maxillary lesions. RESULTS: The cytological evaluation revealed that five out of 20 lesions, whose content had been processed by this technique, were odontogenic keratocystic tumors (TOCs), predominantly with keratin and always with parakeratin areas. In the other cases (five dentigerous, five radicular and five residual cysts) there were erythrocytes, inflammatory cells, and cholesterol clefts. CONCLUSION: The cytological assessment through cell block technique was useful as to establishing the differential diagnosis between TOC and other lesions, radicular, residual and dentigerous cysts.
Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Pessoa de Meia-Idade , Biópsia por Agulha , Cisto Dentígero/diagnóstico , Cisto Radicular/diagnóstico , Cistos Odontogênicos/diagnóstico , Diagnóstico Diferencial , Técnicas e Procedimentos Diagnósticos , Tumores Odontogênicos/diagnósticoRESUMO
A case of peripheral squamous odontogenic tumor is described in a 60-year-old female who presented with a sessile growth in the right posterior mandible. Radiographic examination revealed no evidence of a central lesion in bone. With the characteristic histopathological picture of benign-appearing islands of squamous epithelium scattered randomly against a background of mature fibrous connective tissue, the tumor was diagnosed as peripheral squamous odontogenic tumor (PSOT). The epithelial islands showed peripheral cuboidal or flattened cells, microcyst formation, individual cell keratinization, and keratin pearl formation.
Assuntos
Tecido Conjuntivo/patologia , Células Epiteliais/patologia , Epitélio/patologia , Feminino , Neoplasias Gengivais/diagnóstico , Humanos , Queratinas/análise , Pessoa de Meia-Idade , Tumores Odontogênicos/diagnósticoRESUMO
De los quistes odontogénicos el quiste dentígero (QD) ocupa el segundo lugar en frecuencia, siempre asociado a la corona de un diente retenido, tiene predilección por el género masculino en la segunda y tercera década de la vida. En algunas ocasiones se puede observar deformidad facial por expansión de las corticales óseas del hueso comprometido. Radiográficamente se aprecia imagen radiolúcida circunscrita relacionada a la corona de un diente no erupcionado o en desarrollo. Se presentan dos casos pediátricos del sexo femenino de 6 y 15 años de edad. La niña de 6 años llega a consulta por preocupación de la madre al observarse un aumento de volumen en el maxilar superior del lado derecho, el examen clínico mostró expansión cortical de la tabla vestibular de la zona del primer molar primario superior derecho, el examen radiográfico revela imagen radiolúcida rodeando la corona de un diente retenido que corresponde al primer premolar permanente. La otra paciente acude a consulta por deformidad facial y al examen clínico se observa expansión de la cortical ósea vestibular mandibular del lado izquierdo ocasionando asimetría facial, al estudio radiográfico se observa imagen radiolúcida circunscrita que se extiende desde el segundo molar hasta la rama mandibular asociada a un tercer molar retenido. En ambos casos se planificó extirpación quirúrgica previa punción de las mismas para descartar su naturaleza quística, resultando como diagnóstico definitivo: Quiste Dentígero. Se resalta el hecho de que estos dos casos difieren en cuanto al comportamiento epidemiológico clásico, frecuente en el género masculino y entre segunda y tercera década de la vida
Of odontogenic cysts the cyst is second in frequency, always associated with the crown of an impacted tooth, has a predilection for the male gender in the second and third decade of life. Sometimes you can see facial deformity expansion of cortical bone. Radiographically circumscribed radiolucency is seen related to the crown of an unerupted tooth or developing. There are two female pediatric cases of 6 and 15 years of age. The 6 year old girl comes to consultation by the mother's concern to see an increase of volume in the right upper jaw, clinical examination showed cortical expansion of the buccal plate of the primary molar region of the first upper right, the radiographic examination reveals radiolucency surrounding the crown of an impacted tooth that corresponds to the first premolar. The other patient comes for consultation facial deformity and the clinical examination shows expansion of the cortical bone of the left mandibular buccal causing facial asymmetry, the radiographic study lucid radio image shows circumscribed extending from the second molar to the ramus associated a third molar. In both cases, surgical removal was planned after the same puncture to rule out cystic nature, resulting as definitive diagnosis: dentigerous cyst. It highlights the fact that these two cases differ in the classic epidemiological pattern, common in the male, and between second and third decades of life
Assuntos
Humanos , Adolescente , Feminino , Criança , Dente Impactado/complicações , Cisto Dentígero/diagnóstico , Tumores Odontogênicos/diagnóstico , OdontopediatriaRESUMO
Existen lesiones de considerable tamaño ubicadas tanto en el maxilar como en la mandíbula que constituyen una entidad propia con típicos hallazgos histopatológicos. Este tipo de lesiones son localmente agresivas y presentan una frecuente tendencia recidivante como lo son por ejemplo los tumores odontogénicos quísticos queratinizantes El tratamiento de los mismos sigue siendo controversial. Como conceptos terapéuticos están la marsupialización, la resección de las lesiones de gran tamaño y la descompresión quirúrgica de las mismas, siendo este último en particular el objeto de estudio del presente trabajo. Se presentan dos casos de pacientes con Síndrome de Nevus de Células Basales (también conocido como Síndrome de Gorlin - Goltz) el cual es un desorden autosómico dominante en el que aparecen múltiples alteraciones, las más frecuentes son la presencia de carcinomas de células basales en piel, los Tumores Odontogénicos Quísticos Queratinizantes en los huesos maxilares y otras alteraciones óseas, en dichos casos se valora la importancia de la historia clínica, el examen radiológico y tomográfico, el estudio histopatológico y el papel del odontólogo, ya que su diagnóstico se puede establecer en base a los tumores odontogénicos quísticos queratinizantes que se encuentren y a la interconsulta con médicos especialistas y a estudios complementarios como la radiografía de tórax. El tratamiento que se utilizó en ambos casos fue realizado en dos fases, en una primera etapa se realizó la descompresión quirúrgica de la lesión con el fin de evitar complicaciones tales como fracturas mandibulares, lesiones a dientes y estructuras vecinas; posteriormente se llevó a cabo la enucleación total en conjunto con la osteotomía periférica.
There are considerably big lesions, located in the maxilla and jaw that constitutes an entity with typical histological characteristics. These lesions are locally aggressive and have an important tendency to recidivate, for example, keratinizing odontogenic cystic tumors. The treatment of this entity continues being controversial. As therapeutic options marsupialization, resection of big lesions and surgical decompression has been used, being the last one particularly the subject of study in this work. Two cases of patients with basal cell nevus syndrome are presented, known as Gorlin Goltz syndrome too, which is an autosomal disorder characterized by multiple alterations, the more common are the presence of nevoid basal cell carcinoma in skin, keratinizing odontogenic cystic tumors in the maxilla and jaw, and other bone alterations. In this cases the clinic history or anamnesis, radiologic and tomographic studies, histopathological study and the dentist role are highly valued because diagnostic can be established studying the keratinizing odontogenic cystic tumors, consultation with other specialists and studying complementary studies like thoracic radiography. The treatment performed in both cases was biphasic; first phase consisted in surgical decompression of lesion to avoid complications like mandibular fracture, tooth lesions and neighbor structures damage, after that in the second phase enucleation of the lesion was made with peripheral osteotomy.