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下颌骨牙源性腺样瘤(AOT):手术随访

[Adenomatoid odontogenic tumor (AOT) of the mandible: a surgical follow-up].

作者信息

Schirmer I, Reichart P A

机构信息

CharitéCentrum 3 für Zahn-Mund- und Kieferheilkunde, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin, Germany.

出版信息

Mund Kiefer Gesichtschir. 2007 Nov;11(5):291-4. doi: 10.1007/s10006-007-0072-6. Epub 2007 Sep 6.

DOI:10.1007/s10006-007-0072-6
PMID:17828424
Abstract

The AOT is a relative rare benign odontogenic tumor. It most often appears in the canine region of the maxilla and mandible in young patients. Radiolucencies in the region of non-erupted or vital teeth may produce diagnostic problems. The histological diagnosis of AOT is characterised by odontogenic epithelium, ductlike structures, amyloid-like material and calcifying areas. Case report A female patient of eleven years and ten months was referred for surgical exposure of the left mandibular canine by an orthodontist. This tooth was retained and root formation was incomplete. Radiologically, a radiolucency was seen, extending distally from the crown of the tooth towards the root. The deciduous tooth 73 was extracted and the retained left mandibular canine was surgically exposed. Healing was without result and the tooth was moved orthodontically. Two years later the tooth was seen in regular position and occlusion. Vitality tests were positive, distally to the tooth a 1.5[Symbol: see text]mm periodontal pocket was disclosed. A large radiolucency around the root of the tooth was seen. Supposing a cystic lesion a surgical intervention was performed without removal of the tooth. Histopathologically, an AOT was revealed. Conclusions In the sequence of surgical interventions it is highly likely that already at the first operation an AOT was present, however, went unnoticed clinically. The histological diagnosis of an AOT was only revealed after a second operation including tumor removal. In spite of surgical removal of the AOT the involved tooth found its position in the dental arch.

摘要

腺样牙源性肿瘤(AOT)是一种相对罕见的良性牙源性肿瘤。它最常出现在年轻患者上颌骨和下颌骨的尖牙区。未萌出或活髓牙区域的透射影可能会产生诊断问题。AOT的组织学诊断特征为牙源性上皮、导管样结构、淀粉样物质和钙化区域。病例报告:一名11岁10个月的女性患者被正畸医生转诊,要求对左下颌尖牙进行手术暴露。该牙滞留且牙根形成不完全。影像学检查可见一个透射影,从牙冠向牙根远端延伸。拔除乳牙73,并对滞留的左下颌尖牙进行手术暴露。愈合情况不佳,遂对该牙进行正畸移动。两年后,该牙位置和咬合正常。活力测试呈阳性,在牙齿远端发现一个1.5毫米的牙周袋。可见牙齿根部周围有一个大的透射影。考虑为囊性病变,在未拔除牙齿的情况下进行了手术干预。组织病理学检查显示为AOT。结论:在一系列手术干预过程中,很可能在第一次手术时就已存在AOT,但临床上未被注意到。AOT的组织学诊断直到包括肿瘤切除的第二次手术后才得以揭示。尽管手术切除了AOT,但受累牙齿仍在牙弓中找到了其位置。

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引用本文的文献

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A case report and short review on changing trends in the site of occurrence of adenomatoid odontogenic tumor: Unravelling the past 15 years.腺样牙源性肿瘤发生部位变化趋势的病例报告及简要综述:解读过去15年
Dent Res J (Isfahan). 2016 Sep;13(5):462-471. doi: 10.4103/1735-3327.192312.

本文引用的文献

1
An updated clinical and epidemiological profile of the adenomatoid odontogenic tumour: a collaborative retrospective study.牙源性腺样瘤的最新临床与流行病学特征:一项合作性回顾性研究
J Oral Pathol Med. 2007 Aug;36(7):383-93. doi: 10.1111/j.1600-0714.2007.00536.x.
2
Adenomatoid odontogenic tumour: facts and figures.腺样牙源性肿瘤:事实与数据。
Oral Oncol. 1999 Mar;35(2):125-31. doi: 10.1016/s1368-8375(98)00111-0.
3
The adenomatoid odontogenic tumour. Ameloblastic adenomatoid tumour or adeno-ameloblastoma.腺样牙源性肿瘤。成釉细胞腺样肿瘤或腺成釉细胞瘤。
Acta Pathol Microbiol Scand. 1969;75(3):375-98.
4
Adenomatoid odontogenic tumor: biologic profile based on 499 cases.腺样牙源性肿瘤:基于499例病例的生物学特征
J Oral Pathol Med. 1991 Apr;20(4):149-58. doi: 10.1111/j.1600-0714.1991.tb00912.x.