Shiratsuchi Hiroshi, Namaki Shunsuke, Tamagawa Takaaki, Hosaka Machi, Yonehara Yoshiyuki
Department of Oral and Maxillofacial Surgery Ⅱ, Nihon University School of Dentistry, Tokyo, JPN.
Cureus. 2024 Aug 5;16(8):e66214. doi: 10.7759/cureus.66214. eCollection 2024 Aug.
Delayed eruption of permanent teeth during the replacement period is relatively common in clinical practice; however, impaction of the mandibular first molar is rare. There are various causes of delayed eruption of permanent teeth such as odontogenic cysts and tumors. This article describes the management of two odontogenic tumors that caused the delayed eruption of the mandibular first molar. In Case 1, an eight-year-old boy was diagnosed with an unerupted right mandibular first and second molar that had an odontogenic tumor around them. Radiographic examination revealed well-defined unilocular radiolucency with impacted first and second molars and scattered radiographic opaque images at the right mandibular. The lesion was completely curettaged with extraction of the second molar, and the first molar was fenestrated. Pathological microscopic examination provided the diagnosis as an ameloblastic fibro-odontoma. In Case 2, an 11-year-old boy was diagnosed with an unerupted right mandibular first molar that had an odontogenic tumor around it. Radiographic examination revealed well-defined unilocular radiolucency with an impacted first molar and scattered radiographic opaque images at the right mandibular The lesion was completely curretaged, and the first molar was fenestrated. Pathological microscopic examination provided the diagnosis of odontoma. Among these two cases, the preserved first molar erupted at each regular position. We demonstrated that even if an odontogenic tumor is present along with an impacted molar, removal of the tumor can result in the eruption of the impacted tooth.
恒牙替换期萌出延迟在临床实践中较为常见;然而,下颌第一磨牙阻生却较为罕见。恒牙萌出延迟有多种原因,如牙源性囊肿和肿瘤。本文描述了两例导致下颌第一磨牙萌出延迟的牙源性肿瘤的治疗情况。病例1中,一名8岁男孩被诊断为右侧下颌第一、第二磨牙未萌出,且其周围存在牙源性肿瘤。影像学检查显示,右侧下颌有边界清晰的单房性透射区,第一、第二磨牙阻生,并有散在的不透光影像。病变被彻底刮除,同时拔除了第二磨牙,并对第一磨牙进行开窗处理。病理显微镜检查诊断为成釉细胞纤维牙瘤。病例2中,一名11岁男孩被诊断为右侧下颌第一磨牙未萌出,其周围存在牙源性肿瘤。影像学检查显示,右侧下颌有边界清晰的单房性透射区,第一磨牙阻生,并有散在的不透光影像。病变被彻底刮除,并对第一磨牙进行开窗处理。病理显微镜检查诊断为牙瘤。在这两例中,保留的第一磨牙均在各自正常位置萌出。我们证明,即使存在牙源性肿瘤并伴有磨牙阻生,切除肿瘤仍可使阻生牙萌出。