Spini Pedro Henrique Rezende, Spini Túlio Humberto, Servato João Paulo Silva, Faria Paulo Rogério de, Cardoso Sérgio Vitorino, Loyola Adriano Mota
Laboratory of Pathology, Dental School, Federal University of Uberlândia, MG, Brazil.
Braz Dent J. 2012;23(5):597-600. doi: 10.1590/s0103-64402012000500022.
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.
本文描述了一例罕见的巨大复合性牙瘤病例，该牙瘤影响了一名9岁男孩的下颌骨联合处。由于其尺寸较大，病变导致皮质骨扩张、牙齿移位和阻生，这些临床体征在牙瘤中很少被描述。采用局部麻醉下的口内入路，以保守方式手术切除病变。经过7年的随访，所有牙齿均已萌出，下颌骨完全愈合。由于其影像学上的混合透射线和阻射线表现以及膨胀性生长，必须将巨大复合性牙瘤与其他更具侵袭性的混合性牙源性肿瘤进行鉴别诊断，如成釉细胞纤维牙瘤、牙釉质成釉细胞瘤和囊性钙化牙源性肿瘤。对于此类病变的治疗，保守方法似乎是合适的。
