RESUMEN
This paper describes an exceptional case of an enormous complex odontoma affecting the mandibular symphysis of a 9-year-old boy. Because of its dimensions, the lesion produced cortical bone expansion, dental displacement and impactation, which are clinical signs very seldom described for odontomas. The lesion was surgically excised in a conservative way using an intraoral approach with local anesthesia. After 7 years of follow up, all teeth had erupted and the mandibular bone healed totally. Because of its radiographic mixed radiolucent and radiopaque appearance and its expansive growth, it is imperative to make the differential diagnosis of giant complex odontoma for other more aggressive mixed odontogenic tumors, such as ameloblastic fibro-odontoma, odotoameloblastoma and cystic calcified odontogenic tumor. Conservative approach appears to be indicated in the treatment of such lesions.
Asunto(s)
Mandíbula/patología , Neoplasias Mandibulares/diagnóstico , Odontoma/diagnóstico , Niño , Humanos , Masculino , Mandíbula/diagnóstico por imagen , Neoplasias Mandibulares/cirugía , Odontoma/cirugía , RadiografíaRESUMEN
This paper describes an exceptional case of an enormous complex odontoma affecting the mandibular symphysis of a 9-year-old boy. Because of its dimensions, the lesion produced cortical bone expansion, dental displacement and impactation, which are clinical signs very seldom described for odontomas. The lesion was surgically excised in a conservative way using an intraoral approach with local anesthesia. After 7 years of follow up, all teeth had erupted and the mandibular bone healed totally. Because of its radiographic mixed radiolucent and radiopaque appearance and its expansive growth, it is imperative to make the differential diagnosis of giant complex odontoma for other more aggressive mixed odontogenic tumors, such as ameloblastic fibro-odontoma, odotoameloblastoma and cystic calcified odontogenic tumor. Conservative approach appears to be indicated in the treatment of such lesions.
Descrevemos um caso excepcional de um odontoma complexo gigante afetando a sínfise mandibular em um menino de nove anos de idade. Devido à sua dimensão esta lesão produziu expansão da cortical óssea, deslocamento dentário e impactação, sinais clínicos muito raramente descritos para odontomas. A lesão foi extirpada cirurgicamente de forma conservadora, utilizando uma abordagem intra-oral com anestesia local. Depois de sete anos de seguimento todos os dentes se encontram erupcionados e o osso mandibular totalmente curado. Devido à sua aparência radiográfica, mista radiolúcida e radiopaca, e seu crescimento expansivo, é imperativo fazer o diagnóstico diferencial de odontoma complexo gigante para outros tumores odontogênicos mistos mais agressivos, como o fibro-odontoma ameloblástico, odotoameloblastoma e tumor odontogênico cístico calcificante. Uma abordagem conservadora parece ser indicada no tratamento dessas lesões.
Asunto(s)
Niño , Humanos , Masculino , Mandíbula/patología , Neoplasias Mandibulares/diagnóstico , Odontoma/diagnóstico , Mandíbula , Neoplasias Mandibulares/cirugía , Odontoma/cirugíaRESUMEN
Regional odontodysplasia (RO), also known as ghost teeth, is an unusual nonhereditary developmental anomaly of tooth formation that characteristically affects enamel and dentin formation of the primary and/or permanent dentition. In the present paper, we report a case of RO affecting a 7-year-old boy, with 9 years of follow-up. During this time, progressive development of dental tissue was observed, including complete root formation. However, delayed dental eruption was evident. In view of these findings, we discuss the clinical presentation, pathogenesis, differential diagnosis, and treatment of RO.