Ameloblastic fibro-odontoma: A case report

Ameloblastic fibro-odontoma (AFO) is a rare, benign, slow-growing odontogenic tumor, generally asymptomatic and more prevalent in children and adolescents. We report a case of AFO in the mandible of an eight-year-old Caucasian male patient, and review the literature. Intraoral examination revealed a swelling extending from the deciduous second molar to the retromolar triangle, covered with normal mucosa. A panoramic radiograph showed a large, well-demarcated radiolucency with radiopaque areas. The provisional diagnosis was of AFO, and so an incisional biopsy was performed. Histologically, the lesion was composed of connective tissue resembling the dental papilla, with epithelial strands or islands, as well as denticles and amorphous masses of enamel and dentin consistent with a diagnosis of AFO. Surgical excision and curettage of the lesion were performed. The patient has been monitored for eight years and the lesion has not recurred.

Importance of cone beam computed tomography for diagnosis of calcifying cystic odontogenic tumor associated to odontoma. Report of a case

The calcifying cystic odontogenic tumour (CCOT) is a rare benign cystic neoplasm not infrequently associated with odontoma. This report documents a case of CCOT associated with compound odontoma arising in the anterior maxilla in a 25-year-old woman. Conventional radiographs showed a large calcified mass with poorly visualized radiolucent margins. The extent and condition of the internal structure of the CCOT associated with odontoma was able to be determined based on radiographic findings from cone beam computed tomography. This advanced image technique proved to be extremely useful in the radiographic assessment of this particular neoplasm of the jawbones.

Alternativa de tratamento simplificado e integrado da retenção intraóssea de incisivo central superior, associada a odontoma: relato de caso

Permanent teeth impaction is highly prevalent among brazilian people. Its etiology is related to local and general factors association. Permanent teeth retention compromises dental occlusion and when anterior teeth are involved, it also brings esthetics impairments which lead to psychological disturbance. Early diagnosis and adequate treatment are extremely important to solve not only occlusal problems but also psychological aspects. Orthodontic traction of impacted teeth can be conducted by using fixed or removable appliances. Although it depends on patient compliance the use of removable appliances provides an anchorage based on the teeth and the palate reducing undesirable side effects. This paper describes the case of a fourteen years old female patient whose right maxillary central incisor was adequately tractioned with a removable orthodontic appliance. Removable orthodontic devices were used at first to reposition teeth in maxillary anterior area what provided adequate space to allow the placement of the impacted incisor and after were also used to traction and position this tooth. The procedure described seemed to be effective, non expensive and a viable treatment to be performed even on the scope of public health services, extending orthodontic treatment to a higher number of patients.

Impacted permanent incisors associated with compound odontoma

Odontomas are the most common odontogenic tumours of the maxillary bones, characterised by a slow growth and benign behaviour. They are usually small, asymptomatic and diagnosed after routine radiographic examination. The aim of this study was to report a case of a compound odontoma in the anterior maxilla of a 7-year-old girl, which was causing the impaction of the maxillary right central and lateral incisors, as well as the prolonged retention of the corresponding primary teeth. We also aimed to review the literature about these tumours, since they are not part of the dentist's day-to-day clinical practice. The clinical and radiographic features, the diagnosis and treatment of the case were discussed in this work.

Odontoma em pacientes odontopediátrico: diagnóstico e tratamento. Relato de caso clínico.

Odontoma is a term that refers to a benign tumor of odontogenic and mixed nature, composed of epithelial and mesenchymal components. Histologically, they are compounds of different configurations including dental enamel, dentin, cementum and in some cases the pulp tissue. A slow growing asymptomatic tumor, odontoma is usually discovered through routine radiographic examination. A 3-year old male patient sought care at the School of Dentistry’s Baby Clinic (UNESP-Araçatuba), complaining of “small ball close to the teeth.” During the interview, the mother reported that the lesion was observed soon after a trauma, and evolved in less than one month. An ulcerated lesion with a 0.8 cm diameter was found during intraoral clinical examination. It was located in the inferior and anterior region of the mouth, between teeth 81 and 82, and there was also crown distalization. A radiographic examination showed a radiolucent area and root distance. In the absence of clinical and radiographic characteristics suggesting a case of odontoma, the differential diagnosis was peripheral giant cell lesion and pyogenic granuloma. So the area was punctured. Nonetheless, due to the absence of liquid, the surgical removal of the lesion was performed, followed by histological examination, which showed the definite diagnosis of a suggestive case of emerging odontoma.

Odontoma composto: relato de caso clínico

Os odontomas são os tipos mais comuns de tumores odontogênicos, sendo sua constituição principalmente de esmalte e dentina, com quantidade variável de cemento e polpa. Apresenta relação com dentes inclusos e sua etiopatogenia é desconhecida. Radiograficamente pode ser classificado como composto ou complexo. Acomete com mais frequência pacientes entre a primeira e segunda década de vida, e não há predileção por sexo. Localiza-se principalmente em região anterior de maxila, assintomático e tem associação com dentes inclusos e supranumerários. Neste trabalho relatamos um caso clínico, cuja paciente foi encaminhada para avaliação devido a ausência do dente 33. O diagnóstico clinico-radiográfico inicial foi de odontoma composto. Realizou-se a remoção cirúrgica da lesão e do dente incluso tendo o exame histopatológico confirmado o diagnóstico de odontoma composto.

Peripheral compound odontoma erupting in the gingiva

Background: Peripheral odontoma arising in the extraosseous soft tissues is rare and if not removed early, may enlarge over time and eventually erupt in the oral cavity. Case presentation: A 15-year-old girl presented with “denticles on the gingiva”. During the intraoral examination, seven small tooth-like structures were found. These were exposed in the anterior left gingiva between the permanent maxillary lateral incisor and canine teeth, and the left first premolar was absent. Radiographic examination revealed irregular tooth-like structures without evidence of bone involvement. Conclusion: The lesion was surgically removed, and the specimens were analyzed histopathologically. The diagnosis of compound odontoma was established. Clinical significance: This is the twelfth reported case of peripheral odontoma in the gingiva and the first one that erupted in the oral cavity.

Odontoma associated with calcifying cystic odontogenic tumor in deciduous dentition: case report

Background: Initially described by Gorlin et al. in 1962, the calcifying cystic odontogenic tumor (CCOT) may be associated with unerupted teeth, ameloblastomas, adenomatoid odontogenic tumors, and, in many cases, with odontomas. It is rare in patients in the first decade of life, particularly involving deciduous teeth. Surgery is the treatment of choice, with low recurrence rates. Case report: We present a clinical case of CCOT associated with odontoma and a missing deciduous tooth in a 3-year-old female patient. The lesion was removed under general anesthesia. The patient has been followed up for 1 year, and no recurrence was found. This appears to be the first report in such a young age

Expression of odontogenic ameloblast-associated protein, amelotin, ameloblastin, and amelogenin in odontogenic tumors: immunohistochemical analysis and pathogenetic considerations

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Ameloblastic fibro-odontosarcoma: a case report

This paper reports one case, of an ameloblastic fibro-odontosarcoma (AFOS) affecting the mandible, in a 12-year-old girl. This neoplasm is a rare odontogenic neoplasm. To the authors' knowledge this is the fifteenth case of AFOS reported in English. The patient's chief complaint was a swelling in the face For 6 months. An incisional biopsy was performed diagnosing the case as all ameloblastic fibroma. After radiography ameloblastic fibro-odontoma was diagnosed. Computed tomography was performed and a stereolithography model made to plan the surgical procedures. A hemimandibulectomy followed by a vascularized fibular flap was then proposed. The surgery was uneventful. Microscopic features diagnosed an AFOS. After 23 months of close follow-up there is no sign of recurrence or metastasis. Dental implants were recently placed in the fibular flap.

Cytokeratins in epithelia of odontogenic neoplasms

Neoplasms and tumours related to the odontogenic apparatus may be composed only of epithelial tissue or epithelial tissue associated with odontogenic ectomesenchyme. The immunohistochemical detection of different cytokeratins (CKs) polypeptides and vimentin has made it easier to explain the histogenesis of many epithelial diseases. The present study aimed to describe the immunohistochemical expression of cytokeratins 7, 8, 10, 13, 14, 18, 19 and vimentin in the epithelial components of the dental germ and of five types of odontogenic tumours. The results were compared and histogenesis discussed. All cells of the dental germ were positive for CK14, except for the preameloblasts and secreting ameloblasts, in which CK14 was gradually replaced by CK19. CK7 was especially expressed in the cells of the Hertwig root sheath and the stellate reticulum. The dental lamina was the only structure to express CK13. The reduced epithelium of the enamel organ contained CK14 and occasionally CK13. Cells similar to the stellate reticulum, present in the ameloblastoma and in the ameloblastic fibroma, were positive for CK13, which indicates a nature other than that of the stellate reticulum of the normal dental germ. The expression of CK14 and the ultrastructural aspects of the adenomatoid odontogenic tumour probably indicated its origin in the reduced dental epithelium. Calcifying odontogenic epithelial tumour is thought to be composed of primordial cells due to the expression of vimentin. Odontomas exhibited an immunohistochemical profile similar to that of the dental germ. In conclusion, the typical IF of odontogenic epithelium was CK14, while CK8, 10 and 18 were absent. Cytokeratins 13 and 19 labelled squamous differentiation or epithelial cells near the surface epithelium, and CK7 had variable expression.

Odontomas in pediatric dentistry: Report of two cases

Odontomas are developmental disturbances which manifest in the form of denticles or amorphous informes masses comprising all dental tissues, especially enamel and dentin, with variable amounts of pulp and cement. We describe here two clinical cases of odontomas in children, focusing on diagnostic means and the importance of early treatment of these lesions. The standard treatment for the two present cases was surgical removal.

Noninvasive aspergillosis as a maxillary antrolith: report of a rare case.

Maxillary antrolithiasis is characterized by masses of tissue of endogenous or exogenous origin that calcify within the maxillary sinuses. Aspergillosis is a fungal disease in which the maxillary sinus is a primary site of infection. Aspergillosis mycetoma, its noninvasive form, is the most prevalent modality of the disease in the maxillary sinuses. In approximately half of the cases reported in the literature, calcification of the fungal mycelia, which later became antroliths, was verified. This article reports a rare case of the accidental discovery of a maxillary antrolith associated with noninvasive aspergillosis in an immunocompetent and asymptomatic 56-year-old woman. The diagnosis and therapeutic procedures used in treating the patient are discussed as well as the probable iatrogenic origin of the fungal pathology.

Sagittal Mandibular Osteotomy for Removal of Intraosseous Lesion

The ramus sagittal split osteotomy or mandibular body is an established technique for correction of dentofacial deformities but can have an accurate indication in cases requiring surgical access to remove lesions or more teeth included in the region of the mandibular angle. The main advantages of this technique are the possibility of preservation of the inferior alveolar nerve bundle and significant reduction in postoperative morbidity. In this article, the authors show a case in which the sagittal osteotomy of the mandible was used to gain access for removal of a lesion (complex odontoma).

Seqüelas em dentes permanentes após trauma nos predecessores decíduos e sua implicação clínica

In regarding to the high prevalence of traumatic dental injuries in primary teeth and the possible disturbances on developing permanent successor germs, an early diagnosis and an adequate establishment of treatment planning are very important to minimize the damage caused by the trauma. Sequelaes can affect the coronal portion (white or yellow-brown discoloration associated or not with enamel hipoplasia, dilacerations of the crown), the root portion (dilaceration, duplication or cessation of root formation) or the whole successor permanent tooth (odontoma sequestration or disturbances of permanent successor eruption). The aim of this study is to make a literature review of the developmental disturbances of permanent teeth followed by traumatic injuries to theirs primary predecessors and to present cases reports to advise the dentists, their patients and parents about the damage that developing permanents teeth can undergo.