Gutiérrez-Maldonado Fernando, González-Alvarez Gustavo Eder, Martínez-Nieto Melissa, Alarcón-Sánchez Mario Alberto, Escoto-Vasquez Lilibeth-Stephania, Heboyan Artak, Rodríguez-Montaño Ruth, Lomelí-Martínez Sarah Monserrat
Department of Medical and Life Sciences, La Ciénega University Center, University of Guadalajara (CUCIENEGA-UdeG), Ocotlán, Jalisco, Mexico.
Department of Integrated Dentistry Clinics, University Center of Health Sciences, University of Guadalajara (CUCS-UdeG), Jalisco, Mexico.
SAGE Open Med Case Rep. 2025 Aug 27;13:2050313X251371958. doi: 10.1177/2050313X251371958. eCollection 2025.
In dental practice, impacted canines are common clinical conditions that compromise tooth mobility, thereby severely affecting functionality and esthetics. They also represent a significant challenge, particularly when associated with odontogenic pathologies such as dentigerous cysts and odontomas. These entities, despite benign, can cause complications, including tooth displacement, root resorption, and alterations in normal eruption, compromising both esthetics and function. We present the case of a 15-year-old female patient with no relevant medical history who attended for orthodontic treatment planning. Computed tomography scans revealed bilateral impaction of the mandibular canines, associated with radiolucent images consistent with dentigerous cysts. A mixed radiolucent-radiopaque image was also observed in the area of the lower right first premolar, suggesting an odontoma. Surgical management was proposed, including enucleation of the cysts, removal of the odontoma, and placement of orthodontic appliances on the exposed canines to facilitate their movement. Histopathological analysis confirmed the diagnosis of two dentigerous cysts and one compound odontoma. In the surgical follow-up, the intervention area evolved satisfactorily, with no signs of complications, such as infection, delayed healing, or recurrence of the lesion. One of the most complex clinical challenges is managing impacted mandibular canines when associated with odontogenic pathologies. The implementation of advanced diagnostic tools such as computed tomography, along with appropriate surgical techniques and strategic orthodontic planning, effectively addresses these clinical presentations. Timely multidisciplinary treatment promotes the resolution of associated pathologies and optimizes dental alignment, contributing to improved masticatory function and facial esthetics. These comprehensive approaches are essential to ensure predictable and successful outcomes in certain complex cases.
在牙科临床实践中，阻生尖牙是常见的临床情况，会影响牙齿的移动性，从而严重影响功能和美观。它们也是一项重大挑战，尤其是当与牙源性病变如含牙囊肿和牙瘤相关时。这些病变尽管是良性的，但可能会引起并发症，包括牙齿移位、牙根吸收以及正常萌出的改变，从而损害美观和功能。我们报告一例15岁女性患者，无相关病史，前来进行正畸治疗计划。计算机断层扫描显示双侧下颌尖牙阻生，并伴有与含牙囊肿一致的透光图像。在右下第一前磨牙区域还观察到混合性透光-不透光图像，提示存在牙瘤。建议进行手术治疗，包括囊肿摘除、牙瘤切除以及在暴露的尖牙上放置正畸矫治器以促进其移动。组织病理学分析证实诊断为两个含牙囊肿和一个复合性牙瘤。在手术随访中，干预区域恢复良好，没有感染、愈合延迟或病变复发等并发症迹象。最复杂的临床挑战之一是处理与牙源性病变相关的下颌阻生尖牙。采用计算机断层扫描等先进诊断工具，结合适当的手术技术和战略性正畸计划，能够有效应对这些临床表现。及时的多学科治疗可促进相关病变的解决并优化牙齿排列，有助于改善咀嚼功能和面部美观。这些综合方法对于确保某些复杂病例获得可预测的成功结果至关重要。
