Faniati Ratna, Sejati Bramasto Purbo, Arindra Pingky Krisna
Resident of Oral and Maxillofacial Surgery Study Program, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia.
Lecture of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia.
Int J Surg Case Rep. 2025 May;130:111287. doi: 10.1016/j.ijscr.2025.111287. Epub 2025 Apr 12.
Odontomas are the most common odontogenic tumors. They can significantly impact dental development, potentially causing tooth impaction or delaying tooth eruption and disturbances in tooth movement, presenting unique challenges in orthodontic treatment. This case series report discusses the complexity and golden time of surgery as management strategies of compound odontomas affecting orthodontic treatment in five cases.
We retrospectively reviewed five patients diagnosed with compound odontomas. Patients complained of their missing canines, mainly on the upper, and in some cases, on the lower jaw. There was no subjective pain, and only one patient complained of gingival swelling on his left maxilla with no changes in size.
Radiograph revealed all of the tumors before orthodontic treatment. CBCT is appropriate to use for surgical approach, and it minimizes complication. An OPG is less costly compared to CBCT. Odontomas were treated by surgical removal because the tumor blocked the pathway of tooth eruption and medialized or distalized teeth. Removal of an odontoma before orthodontic insertion is highly recommended, and the need for surgical removal during the orthodontic treatment may depend on its location. Orthodontic treatment post-surgery achieved functional and aesthetic outcomes.
The multidisciplinary approach involving surgical and orthodontic interventions is critical in managing compound odontomas, emphasizing the necessity for individualized treatment strategies. The golden time of surgical removal of an odontoma is key to the successful treatment of tooth movement to be aligned.
牙瘤是最常见的牙源性肿瘤。它们会对牙齿发育产生重大影响，可能导致牙齿阻生或延迟牙齿萌出，并干扰牙齿移动，给正畸治疗带来独特挑战。本病例系列报告讨论了手术治疗复合性牙瘤影响正畸治疗的复杂性和黄金时机，涉及五例病例的管理策略。
我们回顾性分析了五例被诊断为复合性牙瘤的患者。患者主要抱怨上颌尖牙缺失，部分病例下颌尖牙也缺失。无主观疼痛，只有一名患者抱怨左上颌牙龈肿胀，大小无变化。
在正畸治疗前，X线片显示了所有肿瘤。锥形束计算机断层扫描（CBCT）适用于手术入路，可将并发症降至最低。与CBCT相比，全景片（OPG）成本较低。牙瘤通过手术切除进行治疗，因为肿瘤阻塞了牙齿萌出路径，并使牙齿向近中或远中移位。强烈建议在正畸治疗前切除牙瘤，正畸治疗期间是否需要手术切除可能取决于其位置。术后正畸治疗取得了功能和美观效果。
手术和正畸干预相结合的多学科方法对于复合性牙瘤的管理至关重要，强调了个体化治疗策略的必要性。切除牙瘤的黄金时机是成功使牙齿排列整齐的关键。
