Tratamento de odontoma composto e cisto dentígero: relato de caso / Treatment of compound odontoma and dentigeral cyst: case report

Introdução: o odontoma é considerado como um frequente tumor odontogênico benigno, podendo ser classificado em tipo composto ou tipo complexo. O cisto dentígero é o mais comum entre os cistos odontogênicos de desenvolvimento, onde envolve a coroa da unidade dentária no nível da junção amelocementária. Há poucos estudos na literatura do encontro das duas lesões, acometendo o mesmo local na cavidade oral. O diagnóstico pode ser constituído por exame clínico e de imagem. Objetivo: apresentar um caso clínico de odontoma composto e cisto dentígero em região de parassínfise mandibular esquerda abordando as caraterísticas clínicas destas duas lesões e as adequadas formas de tratamento. Relato de caso: paciente do sexo masculino, 16 anos de idade, compareceu ao ambulatório do Centro Odontológico da Escola Bahiana de Medicina e Saúde Pública (Salvador, Bahia), portando encaminhamento de ortodontista, solicitando exodontia da unidade dentária 33 inclusa associada a um odontoma. Ao realizar exames físicos e imaginológicos detectou-se a hipótese diagnóstica de odontoma composto associado a unidade dentária, envolto em folículo pericoronário ou cisto dentígero. Foi realizada biópsia excisional das duas lesões e exodontia da unidade. A análise histopatológica confirmou o diagnóstico para odontoma composto associado a cisto dentígero na unidade 33. Ao acompanhamento de 03 meses, paciente apresentou neoformação óssea da região de parassínfise mandibular, mediante a análise de novos exames imaginológicos. Discussão: há poucos estudos na literatura da associação entre as duas lesões, porém relatos afirmam que o odontoma pode ser encontrado associado aos cistos odontogênicos. Por conta da falta de maiores estudos dessa associação, há escassez de recomendações terapêuticas de acordo com faixa etária e extensão do acometimento das lesões. Considerações finais: lesões comumente assintomáticas, tem o diagnóstico constituído por exame clínico e avaliação de exames de imagem(AU)

Introduction: odontoma is considered a frequent benign odontogenic tumor and can be classified as a compound or complex type. The dentigerous cyst is the most common among developmental odontogenic cysts, where it involves the crown of the dental unit at the level of the cementoenamel junction. There are few studies in the literature on the meeting of the two lesions, affecting the same site in the oral cavity. The diagnosis can be made by clinical and imaging examination. Objective: to present a clinical case of compound odontoma and dentigerous cyst in the left mandibular parasymphysis region, addressing the clinical characteristics of these two lesions and the appropriate forms of treatment. Case report: male patient, 16 years old, attended the outpatient clinic of the Centro Odontológico da Escola Bahiana de Medicina e Saúde Pública (Salvador, Bahia), having been referred by an orthodontist, requesting extraction of the included dental unit 33 associated with an odontoma. Upon physical and imaging examinations, the diagnostic hypothesis of a compound odontoma associated with a dental unit, surrounded by a pericoronal follicle or dentigerous cyst, was detected. Excisional biopsy of the two lesions and extraction of the unit were performed. The histopathological analysis confirmed the diagnosis of compound odontoma associated with dentigerous cyst in unit 33. At the 03-month follow-up, the patient presented bone neoformation in the mandibular parasymphysis region, through the analysis of new imaging exams. Discussion: there are few studies in the literature on the association between the two lesions, but reports state that odontoma can be found associated with odontogenic cysts. Due to the lack of further studies on this association, there is a lack of therapeutic recommendations according to age group and extent of lesion involvement. Final considerations: commonly asymptomatic lesions, the diagnosis consists of clinical examination and evaluation of imaging tests(AU)

Odontomas: un reto para el tratamiento interdisciplinario del paciente de ortodoncia / Odontomas: a challenge for the interdisciplinary treatment of the orthodontic patient

El objetivo del presente trabajo es describir las técnicas para el diagnóstico y tratamiento de 3 casos clínicos de odontoma en pacientes ortodóncicos. En el caso 1, se trató a un paciente masculino de 17 años, que acudió para interconsulta con el servicio de ortodoncia, ya que no había erupcionado el canino superior izquierdo y el primer premolar superior izquierdo. El estudio anatomopatológico reveló odontoma complejo con áreas pindborgoides y acumulación de células fantasma. En al caso 2 se trató a un paciente femenino de 15 años. El estudio anatomopatológico reveló odontoma complejo. En el caso 3, se trató a un paciente masculino de 28 años que acudió a rehabilitación integral de su boca, y fue derivado a la cátedra de ortodoncia. En la radiografía panorámica se observó una imagen compatible con odontoma. Se remitió una muestra a anatomía patológica que confirmó el diagnóstico de odontoma. Conclusión: el conocimiento adecuado de las características clínicas, radiológicas y patológicas es necesario para un correcto diagnóstico y tratamiento. Es importante el trabajo interdisciplinario ortodoncista - cirujano para tratar estos casos (AU)

The objective of this work is to describe the techniques for the diagnosis and treatment of 3 clinical cases of odontoma in orthodontic patients. In case 1, a 17-year-old male patient was treated who came for consultation with the orthodontic service, since the upper left canine and the upper left first premolar had not erupted. Pathological study revealed complex odontoma with pindborgoid areas and accumulation of ghost cells. In case 2, a 15-year-old female patient was treated. The anatomopathological study revealed a complex odontoma. In case 3, a 28-year-old male patient was treated who attended comprehensive rehabilitation of his mouth and was referred to the orthodontic department. In the panoramic radiography, an image compatible with odontoma was observed. A sample was sent to pathological anatomy, which confirmed the diagnosis of odontoma. Conclusion: Adequate knowledge of the clinical, radiological and pathological characteristics is necessary for a correct diagnosis and treatment. Interdisciplinary orthodontist-surgeon work is important to treat these cases (AU)

Odontogenic tumors and lesions treated in a single specialist oral and maxillofacial pathology unit in the United Kingdom in 1992-2016.

OBJECTIVES: Odontogenic tumors (ODTs) are a heterogeneous group of lesions derived from elements of tooth-forming tissues. No detailed data on the incidence of odontogenic tumors in the United Kingdom have been published. The aim of this study was to retrospectively describe the range and incidence of odontogenic tumors from 1992 to 2016 in a single specialist unit and to compare this population with others. STUDY DESIGN: By using the Oral and Maxillofacial Pathology database, Sheffield (UK), we included both local and referred consultation cases. A proportion of diagnoses were reclassified in accordance with the 2017 World Health Organization classification. RESULTS: In total, 559 odontogenic tumors were diagnosed. Overall, the most common lesions were ameloblastoma (196 [33.8%]), odontoma (148 [25.5%]), and odontogenic myxoma (37 [6.3%]), but this varied between local and referral case populations, with odontomas being most common in the local population (43%). The sites affected and the gender and age of patients were similar to other Western populations. Malignant ODTs comprised 33 cases (5.7%), of which 9 (27.3%) were ameloblastic carcinoma. The majority of the malignant ODTs comprised referral cases. CONCLUSIONS: Here, we present the first detailed data on ODTs within a UK population, and the pattern of incidence from the local population is similar to other Western populations. The exceptional rarity of malignant ODTs emphasizes the need for specialist centers for their treatment to gain diagnostic experience.

Compound odontoma - morphology, clinical findings and treatment. Case report.

Compound odontomas are benign tumors, composed of odontogenic tissue that has an orderly pattern. These are formed of unilocular conglomerate of multiple calcified structures, some resembling to mini-teeth. A case of a 9-year-old female patient with compound odontoma is reported, highlighting aspects of odontoma's morphology, clinical findings and treatment. The tumor, found in the anterior maxilla, included multiple calcified structures, some of them resembling to mini-teeth (the biggest were about 5 mm), arranged in a conglomerate. The mini-teeth presented a crown and root, different dental tissues, open apices (the root was incompletely formed), and root canal which was evidenced by usage of Kerr K-file needle No. 8. Their surface presented many irregularities. Odontoma associated impaction of maxillary central incisor, and eruption disturbances and malposition of adjacent teeth. In order to minimize side effects, especially when odontoma is localized in an area with great impact on facial esthetics, early diagnosis and proper treatment are of great importance.

Ameloblastic fibroma and ameloblastic fibrosarcoma: A systematic review.

PURPOSE: To integrate the available data published to date on ameloblastic fibromas (AF) and ameloblastic fibrosarcomas (AFS) into a comprehensive analysis of their clinical/radiological features. METHODS: An electronic search was undertaken in July 2017. Eligibility criteria included publications having enough clinical, radiological and histological information to confirm a definite diagnosis. RESULTS: A total of 244 publications (279 central AF tumours, 10 peripheral AF, 103 AFS) were included. AF and AFS differed significantly with regard to the occurrence of patients' mean age, bone expansion, cortical bone perforation and lesion size. Recurrence rates were as follows: central AF (19.2%), peripheral AF (12.5%), AFS (all lesions, 35%), primary (de novo) AFS (28.8%) and secondary AFS (occurring after an AF, 50%). Larger lesions and older patients were more often treated by surgical resections for central AF. Segmental resection resulted in the lowest rate of recurrence for most of the lesion types. AFS treated by segmental resection had a 70.5% lower probability to recur (OR 0.295; P = .049) than marginal resection; 21.3% of the AFS patients died due to complications related to the lesion. CONCLUSIONS: Very long follow-up is recommended for AF lesions, due to the risk of recurrence and malignant change into AFS. Segmental resection is the most recommended therapy for AFS.

Ameloblastic Fibro-Odontoma.

The ameloblastic fibro-odontoma (AFO) is a rare, mixed odontogenic tumor exhibiting the histological characters of the ameloblastic fibroma and complex odontoma. It is comprised of proliferating ectodermal and mesenchymal components of odontogenic tissue as well as enamel and dentin. AFO normally presents as an asymptomatic swelling of the posterior maxilla or mandible and is usually associated with developing teeth, occurring predominantly in children and adolescents. Such lesions are generally found upon radiographic examination of patients whose tooth eruption is delayed. This lesion often includes an unerupted permanent tooth, and extraction of this tooth is a common treatment. The purpose of this report is to describe an AFO in the posterior mandible of a nine-year-old girl for whom enucleation was performed under general anesthesia without extracting the displaced permanent mandibular left second molar. Two years later, the tooth erupted into occlusion without tumor recurrence.

Odontoma compuesto. presentación de un caso / Odontoma compound. presentation of a case

Se presentó el caso clínico de un niño de 8 años de edad, que acude a consulta de Estomatología del Policlínico "Mártires de Jamaica", del municipio Manuel Tames, de la provincia Guantánamo, acompañado de la madre preocupada por la no erupción del diente 21. Al examen clínico se observó ausencia clínica del 21 con espacio para su ubicación con ligero aumento de volumen en el fondo del surco vestibular a nivel de la zona de consistencia dura a la palpación. Se indicó radiografía panorámica observándose imagen radiolúcida con numerosas formaciones radioopacas en su interior que asemejan estructuras dentarias y una banda radiolúcida en su periferia que presuntivamente se diagnosticó como un odontoma compuesto, se remite al segundo nivel de atención para excéresis y diagnóstico definitivo. Se discuten algunas características de su etiología, diagnóstico y tratamiento(AU)

It was presented the clinical case of an 8-year-old boy, who was attended in the clinic of "Mártires de Jamaica" Polyclinic, in Manuel Tames municipality of Guantanamo province, accompanied by the mother concerned about the non-eruption of tooth 21 .On clinical examination, was observed absence of tooth 21 with space for its location with slight increase in volume at the bottom of the vestibular sulcus at the level of the area hard to palpation. Panoramic x-ray is indicated, with a radiolucent image with numerous radio opaque formations that resemble dental structures and a radiolucent band in its periphery presumptively diagnosed as a compound odontoma. It is referred to the second level of attention for excresis and definitive diagnosis. Some characteristics of its etiology, diagnosis and treatment were discussed(AU)

Odontomas: review of the literature and case reports.

Odontomas are one of the most common Odontogenic Tumors of the jaw. The exact etiology of odontomas is unknown. Histologically they are composed of various formations of dental tissue (enamel, dentin, cementum and sometimes pulp). In the WHO classification, they are divided into complex odontoma and compound odontoma. Clinically, odontomas are generally asymptomatic and only in rare cases cause swelling, pain, suppuration or bony expansion. Radiologically, the tumor is initially lucent, but with time, it develops small calcifications, which eventually coalesce to form a radiodense lesion with a lucent rim. Surgical resection is the treatment of choice and there is no recurrence. The aim of this paper is to define the principal characteristics and the treatment of these lesions, based on literature and personal experience.

Diagnóstico precoz y tratamiento oportuno del odontoma compuesto en un niño Peruano de 3 años / Early diagnosis and timely treatment of composite odontoma in a peruvian child of 3 years

Los odontomas son los tumores odontogénicos benignos y asintomáticos más comunes en los maxilares. Generalmenteel diagnóstico y tratamiento ocurren entre la segunda y tercera década de la vida. El propósito del caso que presentamo sexplica que el diagnóstico precoz se puede obtener desde los primeros años de vida con la interpretación de los antecedentes anamnésicos, la evaluación clínica y radiográfica oportuna para realizar el tratamiento temprano de los odontomas, con el objetivo de evitar en los pacientes complicaciones y secuelas a futuro como la retención dentaria, reabsorción o dilaceración radicular, expansión ósea, formación quística y sus recurrencias.

Odontomas are the most common benign and asymptomatic benign tumor in the maxillaries. Diagnostic and treatment generally occur from the second decade of life. The purpose of the case presented explains the historical background,timely clinical and radiographic evaluation allow to obtain early diagnostics and therefore realize early treatment of odontomas, with the objetive to avoid future complications and aftermaths in patients as dental retention, root reabsorptionand dilacerations, bone expansion, cyst formation and recurrence.

Estudo clínico-patológico de odontomas diagnosticados no Laboratório de Patologia Bucal da Faculdade de Odontologia de Pernambuco - FOP / Odontomas Pathological-Clinical Study DiagnosedattheOral Pathology Laboratory from Pernambuco College of Dentistry

O Odontoma é o tipo mais comum de tumor odontogênico. Os odontomas são subdivididos em composto e complexo. Diferem-se histológica e radiograficamente pelo fato de o tipo complexo não apresentar a organização ordenada dos tecidos como o são no tipo composto, no qual estruturas pequenas se assemelham a dentículos. Os odontomas compostos, geralmente, são mais diagnosticados do que a forma complexa. Podem ocupar ambos os maxilares, sendo o tipo composto mais frequente na região ântero-superior e o complexo nas regiões posteriores, superior e inferior. Acometem mais adultos jovens, entretanto sem grandes disparidades quanto aos gêneros. Essa lesão geralmente é assintomática. O objetivo deste trabalho foi analisar os casos de odontomas diagnosticados no Laboratório de Patologia Bucal da Faculdade de Odontologia da Universidade de Pernambuco (FOP/UPE), a fim de verificar a frequência dos tipos clínico-radiográficos, correlacionando com a localização anatômica da lesão e fatores demográficos dos portadores do tumor. A metodologia seguiu: seleção dos casos a partir dos laudos anátomo-patológicos, revisão das lâminas para confirmação diagnóstica e para definição do tipo clínico-radiográfico e obtenção dos dados demográficos constantes na ficha de encaminhamento de cada caso. Foram diagnosticados 59 casos de odontomas, sendo 25 do tipo complexo (42,37%) e 34 do tipo composto (57,63%). A faixa etária mais acometida compreendeu de 11-20 anos, o sexo feminino foi o mais afetado, e a raça branca, a mais predominante, tendo a região ânterosuperior representado a localização anatômica mais frequente... (AU)

The Odontoma is the most common type of odontogenic. Odontomas are subdivided into compound and complex. They differ histologically and radiographically because of the complex type does not present the orderly organization of tissues such as are in the compound type, in which small structures resemble the denticles.Odontomas compounds are generally diagnosed more than complex type. Can occupy both jaws, with the compound type most frequent in the upper anterior region and posterior complex in upper and lower regions. It affects mostly young adults, however no major differences as to gender. This lesion is usually asymptomatic. The objective of this study was to analyze cases of odontoma diagnosed at the Laboratory of Oral Pathology, Faculty of Dentistry, University of Pernambuco (FOP/UPE) in order to verify the frequency of clinical and radiographic types and to correlate with the anatomical location of the lesion and factors demographics of patients the tumor. The methodology followed: selection of cases from the pathological files, review of slides for diagnostic confirmation reports and to define the clinical and radiographic type, and obtain demographic data contained in the routing record of each case. Were diagnosed 59 cases of patients with odontoma, complex type were 25 (42.37 %) and 34 of the composite type (57.63 %) were diagnosed . It was concluded that the most affected age group was between 11-20 years, females were more affected, the white race was the most prevalent, and the anterosuperior region represented the most frequent anatomical location... (AU)

Bilateral coronoid hypoplasia and complex odontoma: a rare concurrence of developmental pathology and odontogenic tumour of the mandible.

We present a rare case of concurrent bilateral coronoid hypoplasia and complex odontoma in the mandible, with replacement of missing posterior teeth in both sides of the lower jaw. A 20-year-old woman was diagnosed with bilateral occurrence of coronoid hypoplasia and unerupted complex odontoma after radiographic and histopathological examination. The patient was surgically treated with complete removal of the unerupted complex odontoma and prosthetic replacement of the missing teeth.

Elodontoma in Two Guinea Pigs.

Elodontoma was diagnosed in two pet guinea pigs, one involving a maxillary premolar tooth and the other affecting a mandibular incisor tooth. Diagnostic imaging, including radiographs, computed tomography, and oral endoscopy was performed in order to quantify dental disease. Diagnostic imaging was also used to guide treatment of acquired dental disease, which included intraoral restoration of normal occlusal plane and tooth extraction using an extraoral approach. These are the first histologically confirmed cases of elodontoma in guinea pigs.

Plan preventivo terapéutico integral y recuperación del equilibrio oclusal en odontopediatría: caso clínico / Comprehensive preventive and therapeutic plan and oclusal balance recovery in pediatric dentistry: a clinical case

Paciente de 12 años de edad, sexo femenino, derivada a la Cátedra de Odontopediatría, Facultad de Odontología, UdelaR. Presenta dentición mixta, ausencia del 4.2 y falta de espacio para su erupción, persistencia del 8.3, desplazamiento dentario, desvío de línea media inferior a derecha y diastemas ánteroinferiores, insuficientes para ubicar el diente retenido. La relación molar sagital es clase II de Angle, con falta de espacio para la erupción del 1.3. Radiográficamente se identifica un Odontoma compuesto, traba de erupción del 4.2 y 4.3. El plan de tratamiento integral consta en una primera etapa de educación para la salud, control de la infección, refuerzo del huésped y asesoramiento dietario. Una segunda etapa, ortodóncico-quirúrgica: instalación de aparatología ortodóncica para recuperar espacio y centrar línea media; eliminación quirúrgica del odontoma; ubicación en la arcada de los dientes retenidos y correcta relación canina y molar. Recuperada la armonía oclusal, se establecen controles programados.

The pacient is a 12 years old girl derived to the Pediatric Department, Faculty of Dentistry, UdelaR. She presents mixed dentition absence of 4.2 and space loss of its eruption, persistence of 8.3, with lower midline deviation to the right; the anterior sector diastemas are insufficents to locate the retained tooth. Sagittal molar relationship is Class II Angle, with loss of space for the eruption of 1.3. Radiographically, compound odontoma had prevented the eruption of 4.2 and 4.3. The integral treatment plan consists in a first stage of health education, infection control, strengthening the host and dietary advice. The second stage, orthodontic-surgery: the installation of orthodontics appliances in order to regain lost space and to center the midline; the surgically odontoma remove: placing the retained teeths held in the arch and a right canine and molar relationship. Recovered occlusal harmony, follow-up control were scheduled.

Ameloblastic fibrosarcoma: a cytologist's perspective.

Fine-needle aspiration cytology of a case of ameloblastic fibrosarcoma (AFS), an unusual odontogenic tumor related to ameloblastoma (AB), was performed in a 25-year-old female with a 1 cm swelling in the left lower orbital region along with involvement of zygomatic region. Aspiration of the tumor yielded a cellular sample composed predominantly of mesenchymal element and few clusters representing epithelial component showing tall columnar cells with peripheral palisading. Detailed cytomorphological features of AFS are discussed along with differential diagnosis from other tumors such as AB, desmoplastic AB, odontogenic fibroma, ameloblastic fibrodentinoma and ameloblastic fibro-odontoma, ameloblastic fibroma.

Odontoma compuesto maxilar: reporte de un caso y revisión de la literatura / Maxillary compound odontoma: report of a case and review of the literature

Los odontomas son los tumores odontogénicos más frecuentes. Se presenta una revisión de la literatura, seguida de un reporte de un odontoma compuesto en el maxilar superior en un paciente de sexo femenino de 17 años de edad, asociado con la ausencia del canino permanente. El tumor fue enucleado y se realizó la correspondiente biopsia para confirmación del espécimen. Se recomendó al paciente realizarse tratamiento de rehabilitación oral para corregir la maloclusión

Odontomas are the most common odontogenic tumors. A literature review of the odontomas is presented followed by a case report of a compound odontoma of the anterior maxillar in a a 17 year old associates to not eruptioned of canine. The tumor was enucleated and the corresponding biopsy was performed for confirmation of the specimen. It was recommended the patient performed oral rehabilitation treatment to correct malocclusion

Gingival peripheral odontoma in a child: case report of an uncommon lesion

Odontoma in an extraosseous location represents a challenge for diagnosis. This article reports a case of peripheral odontoma and its clinical presentation, histological evaluation and treatment. A 12-year-old boy reported a firm asymptomatic gingival mass in the anterior maxilla with two years of evolution. The procedures for diagnosis included intraoral examination, excisional biopsy and histological analysis. The diagnosis was peripheral odontoma. The follow-up revealed no sign of recurrence. Peripheral odontoma is rare and the differential diagnosis with other gingival masses is rather difficult and must include inflammatory and reactive processes. The definitive diagnosis is based on microscopic features.

Otodental syndrome.

The otodental syndrome also named otodental dysplasia, is characterised by a striking dental phenotype known as globodontia, associated with sensorineural high frequency hearing loss and eye coloboma. Globodontia occurs in both primary and permanent dentition, affecting canine and molar teeth (i.e. enlarged bulbous malformed posterior teeth with almost no discernable cusps or grooves). The condition appears to be inherited in an autosomal dominant mode, although sporadic cases have been reported. It is a rare disease, a few families have been described in the literature. In the British family, the locus for oculo-oto-dental syndrome was mapped to 20q13.1 within a 12-cM critical chromosomal region. Dental management is complex, interdisciplinary and will include regular follow up, scheduled teeth extraction and orthodontic treatment. Hearing checks and, if necessary, hearing aids are mandatory, as well as eye examination and ad hoc treatment if necessary.

Fibroma ameloblástico: relato de caso e revisão da literatura / Ameloblastic fibroma: a case report and literature review

O Fibroma Ameloblástico é considerado uma neoplasia benigna rara que representa cerca de 2 porcento dos neoplasmas odontogênicos. É caracterizado pela proliferação simultânea dos tecidos epiteliais e mesenquimal, sem formação de esmalte e dentina, geralmente apresentando características clínicas e histopatológicas específicas. Este trabalho teve como objetivo revisar a literatura já apresentada e relatar um caso clínico de Fibroma Ameloblástico em indivíduo de pelo branca, do sexo feminino, com 23 anos de idade. Com base nos aspectos clínicos e radiográficos foram feitas considerações a respeito do diagnóstico diferencial com cisto dentígero e, principalmente, com ameloblastoma. Após biópsia por aspiração e posterior biópsia incisional, o laudo de Fibroma Ameloblástico foi confirmado. Diante disso, optou-se pela remoção cirúrgica, curetagem e proservação

Odontoma composto diagnosticado como achado radiográfico em exame interproximal: relato de caso / Compound odontoma as an incidental finding in finding in bitewing radiographic examination: a case report

O odontoma é o tumor odontogênico mais comum, sendo considerado atualmente mais um hamartoma de crescimento do que propriamente uma neoplasia. Geralmente os odontomas não provocam sintomatologia, de forma que são achados radiográficos comuns principalmente nas duas primeiras décadas de vida. A etiologia dessa patologia é desconhecida, no entanto está freqüentemente associada a dentes inclusos e a dentes supranumerários. Os odontomas são divididos em compostos e complexos; os compostos ocorrem com maior freqüência na região anterior da maxila, enquanto que os complexos são encontrados em ambos maxilares, principalmente na região de molares. Os autores relatam um caso cujo achado radiográfico é de um odontoma composto, abordando os principais aspectos desta patologia bem como o tratamento proposto