Papageorgiou Nikoleta, Pettas Efstathios, Georgaki Maria, Nikitakis Nikolaos G
School of Dentistry, National and Kapodistrian University of AthensGreece.
Department of Oral Medicine & Pathology and Hospital Dentistry, School of Dentistry, National and Kapodistrian University of AthensGreece.
J Oral Maxillofac Res. 2021 Dec 31;12(4):e5. doi: 10.5037/jomr.2021.12405. eCollection 2021 Oct-Dec.
Several lesions of diverse origin may be detected in the oral cavity of children, affecting the oral mucosa, jaws, or teeth. In equivocal cases, their clinicopathologic features may show considerable overlap with various entities. We present a case of a "ring-like" hard mass around the cervical area of a primary tooth in a child and discuss the diagnostic challenges.
A 2.5 year-old girl was presented by her mother for evaluation of a painless left first primary lower incisor lesion, first noticed 5 months ago. Medical history was unremarkable, while previous injury or other incident could not be recalled by the patient's mother. Clinical examination and a periapical radiograph were performed.
The clinical examination revealed a yellowish, non-removable, hard in consistency, cylindrical mass, completely surrounding the cervical area of the left first primary lower incisor. A periapical radiograph was performed, revealing a cylindrical radiopacity of mild intensity encasing the tooth cervix and a diagnosis of a foreign body inserted around the tooth was made. Regular follow-up appointments were attended for the next 4 years in which mild but progressive gingival recession, revealing a larger part of the ring-like structure was observed. At age of 6, the tooth was extracted and a cylindrical structure was detached from the tooth, confirming its nature as a foreign body.
A foreign body surrounding the cervix of a tooth eventually becoming inseparable may cause a peculiar clinical and radiographic appearance and provoke diagnostic difficulties, especially in the lack of a relevant history.
在儿童口腔中可检测到多种不同来源的病变，这些病变会影响口腔黏膜、颌骨或牙齿。在难以明确诊断的病例中，其临床病理特征可能与多种疾病有相当大的重叠。我们报告一例儿童乳牙颈部区域出现的“环状”硬块病例，并讨论诊断方面的挑战。
一名2.5岁女童由其母亲带来评估左侧第一颗下颌乳切牙的无痛性病变，该病变于5个月前首次被发现。病史无异常，而患者母亲无法回忆起之前的损伤或其他事件。进行了临床检查和根尖片检查。
临床检查发现一个淡黄色、不可去除、质地坚硬的圆柱形肿块，完全环绕左侧第一颗下颌乳切牙的颈部区域。进行了根尖片检查，显示有一个轻度密度增高的圆柱形不透光区包裹着牙颈部，诊断为牙齿周围插入了异物。在接下来的4年里定期进行随访，期间观察到轻度但逐渐加重的牙龈退缩，露出了更大一部分环状结构。6岁时，拔除了该牙齿，一个圆柱形结构从牙齿上分离，证实其为异物。
围绕牙齿颈部的异物最终变得难以分离，可能会导致特殊的临床和影像学表现，并引发诊断困难，尤其是在缺乏相关病史的情况下。
