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巨大牙瘤:一项系统的范围综述及病例报告。

Giant odontoma: A systematic scoping review and case report.

作者信息

Memarpour Mahtab, Amiri Mohammad Amin, Mokhtari Niloofar, Sharifinejad Alireza, Hosseini Seyed Mehdi

机构信息

Oral and Dental Disease Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.

Department of Pediatric Dentistry, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Int J Surg Case Rep. 2025 Jan;126:110771. doi: 10.1016/j.ijscr.2024.110771. Epub 2025 Jan 3.

DOI:10.1016/j.ijscr.2024.110771
PMID:39756231
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11758817/
Abstract

INTRODUCTION AND IMPORTANCE

The most common type of odontogenic tumor is odontoma. Cases with at least one dimension (sagittal, axial, or coronal) ≥30 mm were categorized as giant odontomas. This study aimed to provide a scoping review of giant odontoma and present a case report.

CASE PRESENTATION

A 6 years-old boy attended for a routine dental examination without any symptoms. A slight swelling of the right buccal cortex of the posterior maxilla was detected. Radiography views revealed a mixed radiolucent-radiopaque lesion with multiple tooth-like structures. The lesion caused displacement teeth and elevated the floor of the maxillary sinus. The tumor was thoroughly enucleated and the dimensions of the tumor were measured as 32.4 mm × 22.2 mm × 15.3 mm. The specimen was histopathologically examined and was diagnosed as a giant compound odontoma.

CLINICAL DISCUSSION

This scoping review indicated that the mean age of patients diagnosed with giant odontomas was 18.73 years, with no difference between the sexes. The posterior jaws were the most prevalent regions of incidence. The most common clinical manifestations are swelling, pain, and a sensation of hardness on palpation. Giant odontomas are usually diagnosed with panoramic radiography, cone-beam computed tomography, and histopathological examinations. Surgical enucleation is the treatment approach for this tumor.

CONCLUSION

The distinction between giant odontoma and non-giant odontoma is solely based on tumor size. Although giant odontomas are benign, their large size necessitates specific precautions for diagnosis and management. Proper treatment involves critical decisions concerning surgical settings, bone grafting techniques, and jaw stabilization methods.

摘要

引言与重要性

牙源性肿瘤最常见的类型是牙瘤。至少有一个维度(矢状面、轴面或冠状面)≥30毫米的病例被归类为巨大牙瘤。本研究旨在对巨大牙瘤进行范围综述并呈现一例病例报告。

病例介绍

一名6岁男孩前来进行常规牙科检查,无任何症状。检查发现上颌后部右侧颊侧皮质有轻微肿胀。影像学检查显示为一个混合性透射线-阻射线病变,伴有多个牙样结构。该病变导致牙齿移位并抬高了上颌窦底。肿瘤被彻底摘除,并测量肿瘤尺寸为32.4毫米×22.2毫米×15.3毫米。对标本进行了组织病理学检查,诊断为巨大复合性牙瘤。

临床讨论

本范围综述表明,诊断为巨大牙瘤的患者平均年龄为18.73岁,男女之间无差异。颌骨后部是最常见的发病部位。最常见的临床表现是肿胀、疼痛和触诊时有硬感。巨大牙瘤通常通过全景X线摄影、锥形束计算机断层扫描和组织病理学检查来诊断。手术摘除是该肿瘤的治疗方法。

结论

巨大牙瘤与非巨大牙瘤的区别仅基于肿瘤大小。尽管巨大牙瘤是良性肿瘤,但其较大尺寸在诊断和管理方面需要采取特定预防措施。恰当的治疗涉及有关手术环境、骨移植技术和颌骨稳定方法的关键决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6788/11758817/dd541eee2478/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6788/11758817/9d27960bbff9/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6788/11758817/5b0d3f71d933/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6788/11758817/e8eea214430c/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6788/11758817/dd541eee2478/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6788/11758817/9d27960bbff9/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6788/11758817/5b0d3f71d933/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6788/11758817/e8eea214430c/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6788/11758817/dd541eee2478/gr4.jpg

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本文引用的文献

1
Clinicoradiopathologic Analysis of Odontomas: A Retrospective Study of 242 Cases.牙瘤的临床放射病理分析:242例回顾性研究
Dent J (Basel). 2023 Oct 30;11(11):253. doi: 10.3390/dj11110253.
2
Revisiting the History of Odontoma, with Special Reference to Its Original Illustration.重新审视牙瘤的历史,特别参考其原始插图。
Head Neck Pathol. 2023 Dec;17(4):976-983. doi: 10.1007/s12105-023-01593-3. Epub 2023 Oct 19.
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Huge complex composite odontoma of mandible.下颌骨巨大复合型牙瘤。
BMJ Case Rep. 2023 May 5;16(5):e254948. doi: 10.1136/bcr-2023-254948.
4
The SCARE 2023 guideline: updating consensus Surgical CAse REport (SCARE) guidelines.SCARE 2023 指南:更新共识外科病例报告(SCARE)指南。
Int J Surg. 2023 May 1;109(5):1136-1140. doi: 10.1097/JS9.0000000000000373.
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Characteristics, Diagnosis and Treatment of Compound Odontoma Associated with Impacted Teeth.与阻生牙相关的复合性牙瘤的特征、诊断与治疗
Children (Basel). 2022 Oct 2;9(10):1509. doi: 10.3390/children9101509.
6
A Giant Case of Complex Odontoma in the Posterior Mandible of a Young Adult Female: A Spectacular Case Report.一名年轻成年女性下颌后部巨大复杂牙瘤病例:一份精彩的病例报告。
World J Plast Surg. 2022 Mar;11(1):141-147. doi: 10.52547/wjps.11.1.141.
7
Rare giant complex composite odontoma of mandible in mixed dentition: Case report with 3-year follow-up and literature review.混合牙列期下颌罕见巨大复合性牙瘤:病例报告及3年随访并文献复习
Ann Med Surg (Lond). 2022 Feb 7;74:103355. doi: 10.1016/j.amsu.2022.103355. eCollection 2022 Feb.
8
Frequency of Odontogenic Tumors: A Single Center Study of 1089 Cases in Japan and Literature Review.牙源性肿瘤的频率:日本单中心 1089 例研究及文献复习。
Head Neck Pathol. 2022 Jun;16(2):494-502. doi: 10.1007/s12105-021-01390-w. Epub 2021 Oct 30.
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Ann Maxillofac Surg. 2019 Jul-Dec;9(2):429-433. doi: 10.4103/ams.ams_102_19.
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