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下颌骨后部一颗牙瘤扩张的病例报告。

Case report of a dilated odontome in the posterior mandible.

作者信息

Almeida Bruno, Silva António, Pereira Miguel, Silva Mariana, Nunes Stephanie

机构信息

Universidade Católica Portuguesa, Campus Viseu. Estrada da Circunvalação, 3504-505 Viseu, Portugal.

Clínica Médico-Dentária Dr. Silva, Rua Nuno Álvares, 6300 Guarda, Portugal.

出版信息

Int J Surg Case Rep. 2016;20:14-6. doi: 10.1016/j.ijscr.2015.12.048. Epub 2016 Jan 7.

Abstract

INTRODUCTION

Dens invaginatus (dens in dente) is a developmental malformation resulting from an invagination of enamel organ into the dental papilla, beginning at the crown and sometimes extending into the root before calcification occurs. Dilated odontome is the most extreme form of dens invaginatus and it is extremely rare in the posterior mandible.

PRESENTATION OF CASE

A 47 years old female patient with occasional episodes of diffuse pain and discomfort in the left posterior mandibular region. The extra-oral examination showed slight facial asymmetry. Panoramic and intra-oral X-rays show an intraosseous circular formation with radiopaque external limits and radiolucent interior.

DISCUSSION

Computerized tomography scan reveals the bone integrity around the formation, as well as the independence of the neuro-vascular structures of the region. The most likely diagnostic option was dilated odontome. The enucleation procedure was carried out, and the fragments were sent to histopathological examination that revealed a diagnosis consistent with a dilated odontome.

CONCLUSION

In this case, the conservative surgical approach after planning was effective and predictable in the treatment of the pathology and patient symptoms without major complications.

摘要

引言

牙中牙是一种发育畸形,由成釉器向牙乳头内陷入所致,始于牙冠,有时在钙化发生前延伸至牙根。扩张性牙瘤是牙中牙最极端的形式,在下颌后牙区极为罕见。

病例介绍

一名47岁女性患者,左侧下颌后牙区偶尔出现弥漫性疼痛和不适。口腔外检查显示轻度面部不对称。全景片和口腔内X光片显示骨内圆形结构,边界为不透射线,内部为透射射线。

讨论

计算机断层扫描显示该结构周围骨质完整,以及该区域神经血管结构的独立性。最可能的诊断是扩张性牙瘤。实施了摘除手术,将碎片送去做组织病理学检查,结果显示诊断与扩张性牙瘤一致。

结论

在本病例中,经过规划后的保守手术方法在治疗该病变和患者症状方面有效且可预测,未出现重大并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/954c/4818283/919a9dd47dc1/gr1.jpg

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