Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.
Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Oral Dis. 2019 Apr;25(3):676-683. doi: 10.1111/odi.12875. Epub 2018 Jun 8.
The aim of the present study was to integrate the available data published on odontogenic myxoma (OM) into a comprehensive analysis of its clinical/radiological features. Electronic search undertaken in January/2018, looking for publications reporting cases of OM. A total of 377 publications were included. We identified 1,692 lesions, and 695 were used for the analysis of recurrence. There is a predominance of OMs in females and in mandibles. OMs usually present with bone expansion, asymptomatic cortical perforation, and a multilocular appearance. Lesion location (maxilla/mandible), bone expansion, cortical bone perforation, locular radiological appearance, tooth resorption, odontogenic epithelial rests, or angular septa are not associated with recurrence. While curettage (31.3%) showed the highest recurrence rate, marginal resection (1.3%) and segmental resection (3.1%) showed the lowest values. Enucleation + peripheral osteotomy (6.7%) showed better results than enucleation (13.1%) or enucleation + curettage (12.7%). In comparison with unilocular lesions, multilocular ones were significantly more prevalent in mandibles, more often presented expansion and cortical bone perforation, had larger mean size, and were more often treated by segmental resection. Conservative surgical procedures are associated with higher probability of recurrence of OM. Taking into consideration the recurrence rate and morbidity associated with different surgical treatments, tumor enucleation followed by peripheral osteotomy should be considered as the first therapeutic choice.
本研究旨在综合分析牙源性黏液瘤（OM）的现有数据，以全面分析其临床/影像学特征。2018 年 1 月进行了电子检索，以寻找报道 OM 病例的出版物。共纳入 377 篇文献。我们共确定了 1692 个病变，其中 695 个用于分析复发情况。女性和下颌骨中 OM 更为常见。OM 通常表现为骨膨胀、无症状性皮质穿孔和多房性外观。病变位置（上颌骨/下颌骨）、骨膨胀、皮质骨穿孔、腔状影像学表现、牙齿吸收、牙源性上皮剩余或角状隔并不与复发相关。刮除术（31.3%）的复发率最高，而边缘切除术（1.3%）和节段切除术（3.1%）的复发率最低。剜除术+周围截骨术（6.7%）的效果优于单纯剜除术（13.1%）或剜除术+刮除术（12.7%）。与单房性病变相比，多房性病变在下颌骨中更为常见，更常表现为膨胀和皮质骨穿孔，平均大小更大，更常采用节段切除术治疗。保守手术与 OM 更高的复发率相关。考虑到不同手术治疗方法的复发率和发病率，肿瘤剜除术加周围截骨术应被视为首选治疗方法。
