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从多发性复杂牙瘤到骨化纤维瘤的异常颌骨肿瘤进展——病例报告

Anomalous Jaw Tumour Progression from Multiple Complex Odontomas to Cemento-ossifying Fibroma - A Case Report.

作者信息

Jha Sachin, Newaskar Vilas, Maheshwari Bharat

机构信息

Department of Oral and Maxillofacial Surgery, Government College of Dentistry, Indore, Madhya Pradesh, India.

出版信息

Ann Maxillofac Surg. 2025 Jan-Jun;15(1):106-109. doi: 10.4103/ams.ams_167_24. Epub 2025 Apr 4.

Abstract

RATIONALE

Odontomas are benign, asymptomatic odontogenic tumours, while ossifying fibromas are fibro-osseous lesions from the periodontal ligament. The rare transition from odontomas to an ossifying fibroma in the same jaw highlights the need for long-term follow-up.

PATIENT CONCERNS AND DIAGNOSIS

A young adult with multiple odontomas, one of which later changed into a different type of bone-related tumour; ossifying fibroma. The first odontoma was surgically removed 10 years ago, followed by the development of a cemento-ossifying fibroma from an anterior odontoma.

TREATMENT AND OUTCOMES

The fibroma was excised via an intraoral vestibular incision, and the lesion was completely enucleated. Paraesthesia occurred postoperatively due to proximity to the inferior alveolar and lingual nerves but resolved within 3 - 4 weeks. The patient experienced a significant reduction in swelling and improved facial symmetry, with long-term follow-up required for recurrence monitoring.

TAKE-AWAY LESSONS: This case emphasises the potential evolution of odontogenic tumours and the importance of vigilant monitoring.

摘要

理论依据

牙瘤是良性无症状牙源性肿瘤,而骨化性纤维瘤是来自牙周膜的纤维-骨病变。同一颌骨内牙瘤罕见地转变为骨化性纤维瘤,这凸显了长期随访的必要性。

患者情况与诊断

一名年轻成年人患有多个牙瘤,其中一个后来转变为另一种与骨相关的肿瘤;骨化性纤维瘤。第一个牙瘤于10年前手术切除,随后前牙瘤发展为 cemento-ossifying fibroma(此处英文有误,可能是cemento-osseous fibroma,即骨化纤维瘤)。

治疗与结果

通过口内前庭切口切除纤维瘤,病变被完全摘除。由于靠近下牙槽神经和舌神经,术后出现感觉异常,但在3 - 4周内恢复。患者肿胀明显减轻,面部对称性改善,需要长期随访以监测复发情况。

经验教训

本病例强调了牙源性肿瘤的潜在演变以及警惕性监测的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0aee/12321193/39273432c75d/AMS-15-106-g001.jpg

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