Chang Julia Yu-Fong, Wang Jeng-Tzung, Wang Yi-Ping, Liu Bu-Yuan, Sun Andy, Chiang Chun-Pin
School of Dentistry and Graduate Institute of Clinical Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan.
J Formos Med Assoc. 2003 Dec;102(12):876-82.
Odontoma is the most common odontogenic tumor. It includes 2 types, the compound and complex odontomas. There has not been a series study of the clinical and histologic features of odontomas from Taiwan. This study evaluated the clinicopathologic features of odontoma in Taiwanese.
Cases of odontoma treated from 1998 to 2002 identified from medical records were included. The microscopic features, radiographic features, and clinical history of the patients were reviewed and analyzed.
A total of 81 odontomas in 81 patients (36 males and 45 females) were included. There were 62 compound and 19 complex odontomas. The mean age of the patients was 18 years with the majority of odontomas occurring in the first (32%) and second decade (38%) of life. Odontomas had a marked predilection for the maxilla (70%) and for the anterior region of the jaw (83%), particularly for the anterior maxilla (62%). Sixty four (79%) of the 81 odontomas were associated with 80 impacted teeth, including 71 permanent teeth, 2 deciduous teeth, and 7 supernumerary teeth. Of the 71 impacted permanent teeth, the maxillary central incisor (27%) was most commonly affected, followed by the maxillary canine (26%) and mandibular canine (24%). Histologic examination revealed enamel matrix in 90%, dentin in 100%, cementum in 88%, pulp tissue in 96%, fibrous capsule in 93%, ghost cells in 83%, reduced enamel epithelium in 86%, and nests of odontogenic epithelium in 58% of odontomas. Dentigerous cyst was associated with 9% of odontomas.
In this series, odontomas occurred most often in the first and second decade of life. Although complex odontomas are usually found in the posterior jaw, in this Taiwanese series they were most commonly found in the anterior maxilla. Odontoma is frequently associated with an impacted tooth and occasionally with a dentigerous cyst. No recurrence of odontomas was found after surgical excision with follow-up of 1 to 15 years.
牙瘤是最常见的牙源性肿瘤。它包括两种类型，即组合性牙瘤和复杂性牙瘤。目前尚无关于台湾牙瘤临床和组织学特征的系列研究。本研究评估了台湾地区牙瘤的临床病理特征。
纳入1998年至2002年从病历中确诊的牙瘤病例。回顾并分析患者的微观特征、影像学特征和临床病史。
共纳入81例患者的81颗牙瘤（男性36例，女性45例）。其中组合性牙瘤62颗，复杂性牙瘤19颗。患者的平均年龄为18岁，大多数牙瘤发生在生命的第一个十年（32%）和第二个十年（38%）。牙瘤明显好发于上颌骨（70%）和颌骨前部区域（83%），尤其是上颌骨前部（62%）。81颗牙瘤中有64颗（79%）与80颗阻生牙有关，包括71颗恒牙、2颗乳牙和7颗多生牙。在71颗阻生恒牙中，上颌中切牙最常受累（27%），其次是上颌尖牙（26%）和下颌尖牙（24%）。组织学检查显示，90%的牙瘤中有釉质基质，100%有牙本质，88%有牙骨质，96%有牙髓组织，93%有纤维囊，83%有牙骨质小体，86%有釉质发育不全上皮，58%有牙源性上皮巢。9%的牙瘤与含牙囊肿有关。
在本系列研究中，牙瘤最常发生在生命的第一个和第二个十年。尽管复杂性牙瘤通常见于下颌后部，但在本台湾地区系列研究中，它们最常见于上颌前部。牙瘤常与阻生牙有关，偶尔与含牙囊肿有关。手术切除后随访1至15年，未发现牙瘤复发。
