Augusto-Neto Renato Torres, Marinheiro Bruno Henrique, Silveira Heitor Albergoni, Polanco Xiomara Beatriz Jimenez, León Jorge Esquiche, Trivellato Alexandre Elias, Sverzut Cássio Edvard
Department of Oral and Maxillofacial Surgery and Periodontology, Oral and Maxillofacial Surgery, Ribeirão Preto Dental School (FORP/USP); University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
Department of Stomatology, Public Oral Health, and Forensic Dentistry, Oral Pathology, Ribeirão Preto Dental School (FORP/USP); University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
Int J Health Sci (Qassim). 2021 Sep-Oct;15(5):60-63.
Odontomas are common benign odontogenic tumors, being often detected on routine radiographs during the first two decades of life. Rarely, odontoma can interfere with jaw movements, causing mouth opening limitation. A 28-year-old male patient was referred complaining of restriction of mouth opening and mandibular movements, which started 6 months ago. Clinical examination revealed a painless increase of volume on the right maxilla, which interfered the mandibular movements, being associated with pain in these attempts. A well-defined, oval radiopaque lesion in close relationship with the impacted maxillary right third molar was detected in tomographic reconstructions. A surgical excision of the lesion was performed, and microscopy revealed complex odontoma. After 4 months of follow-up, the patient achieved adequate mouth opening and recovered mandibular movements. In the current case, the lesion was placed in a difficult access site, which directly interfered with the displacement of coronoid process. Odontoma should be included in the differential diagnosis when assessing causes of restricted mouth opening.
牙瘤是常见的良性牙源性肿瘤，常在生命的前二十年通过常规X线片被发现。牙瘤很少会干扰颌骨运动，导致张口受限。一名28岁男性患者因6个月前开始出现张口受限和下颌运动受限前来就诊。临床检查发现右上颌无痛性体积增大，干扰下颌运动，并在尝试运动时伴有疼痛。在断层重建中发现一个边界清晰的椭圆形不透光病变，与右上颌阻生第三磨牙关系密切。对该病变进行了手术切除，显微镜检查显示为复合性牙瘤。经过4个月的随访，患者张口度恢复正常，下颌运动也得以恢复。在本病例中，病变位于一个难以触及的部位，直接干扰了冠突的移位。在评估张口受限的原因时，应将牙瘤纳入鉴别诊断。
