Reemplazo mandibular con prótesis personalizada de titanio posterior a la exéresis de ameloblastoma / Mandibular replacement with a customized titanium prosthesis after ameloblastoma excision

Introducción: El ameloblastoma es un tumor odontogénico epitelial benigno con tendencia a la recurrencia local si no se elimina adecuadamente. Las alternativas reconstructivas incluyen el uso de colgajos libres microvascularizados, placas y prótesis personalizada de titanio. Objetivo: Describir un reemplazo hemimandibular con prótesis personalizada de titanio posterior a la exéresis de ameloblastoma. Presentación del caso: Mujer de 44 años de edad, que presentó un hallazgo radiográfico durante la realización de tratamiento pulporradicular del diente número 37. Al realizársele el reconocimiento físico facial mostró aumento de volumen en región geniana izquierda mientras que el examen intrabucal detectó expansión de las corticales en la arcada posteroinferior del mismo lado. Se realizó una radiografía panorámica y tomografía axial computarizada con la que se constató la presencia de imagen radiolúcida, multiloculada, en forma de "pompas de jabón" extendiéndose desde el cuerpo mandibular hasta el cóndilo del lado izquierdo. Se tomó muestra para biopsia, con la cual se constató que se trataba de ameloblastoma con patrón folicular. Se realizó abordaje cervical, segmentaria mandibular con margen de seguridad y exarticulación. Se reemplazó la porción eliminada con prótesis personalizada de titanio. Se mantuvo el chequeo posoperatorio en el que se comprobó una buena evolución. Conclusiones: La cirugía constituyó el pilar de tratamiento utilizado. Una vez realizada la resección quirúrgica se reconstruyó el defecto con prótesis personalizada de titanio, proceder de gran novedad en nuestro medio y útil para restablecer la función y estética(AU)

Introduction: Ameloblastoma is a benign tumor of odontogenic epithelium with a tendency to local recurrence if not removed appropriately. Reconstruction alternatives include the use of microvascularized free flaps, plates and customized titanium prostheses. Objective: Describe a case of mandibular replacement with a customized titanium prosthesis after ameloblastoma excision. Case presentation: A case is presented of a female 44-year-old patient who presented a radiographic finding during pulporadicular treatment of tooth 37. Facial physical examination found an increase in volume in the left genian region, and intraoral observation detected expansion of the corticals in the lower posterior arch of the same side. Panoramic radiography and computed axial tomography showed a multilocular radiolucid image resembling soap bubbles which extended from the mandibular body to the left condyle. A sample was taken for biopsy, which confirmed the diagnosis of follicular pattern ameloblastoma. Segmental mandibular surgery was performed by cervical approach with a safety margin and exarticulation. The portion removed was replaced with a customized titanium prosthesis. Post-operative control showed a good evolution. Conclusions: Surgery was the basic component of the treatment applied. Surgical resection was followed by reconstruction of the defect with a customized titanium prosthesis, a procedure of great novelty in our environment useful to restore function and esthetic appearance(AU)

Hemimandibulectomía por ameloblastoma multiquístico. A propósito de un caso / Multicystic ameloblastoma hemimandibulectomy. A propos of a case

RESUMEN El ameloblastoma es un tumor odontogénico benigno, localmente agresivo y recidivante, con predilección por la región posterior de la mandíbula. Se caracteriza por su agresividad local con muy baja tendencia a metastizarse. El objetivo fue reportar el caso clínico de un paciente con ameloblastoma multiquístico derecho, tratado a través de hemimandibulectomía. Se presentó un paciente masculino, de 44 años de edad, que refirió aumento de volumen del lado derecho de la mandíbula desde hacía aproximadamente un año, acompañado también de otros síntomas, atendido en el Servicio de Cirugía Maxilofacial del Hospital Militar Principal/Instituto Superior, en Luanda, Angola. Los estudios imagenológicos incluyeron radiografía panorámica y tomografía axial computarizada. El diagnóstico clínico patológico fue de ameloblastoma multiquístico. Este tipo de tumor requiere de un adecuado diagnóstico sobre la base de la presentación clínica, localización, tamaño, edad y tipo histológico; de ahí la importancia de conocer las características clínicas e imagenológicas, pues el tratamiento conlleva gran dificultad (AU).

ABSTRACT Ameloblastoma is a benign odontogenic tumor, locally aggressive and recidivist with predilection for back of the jaw, characterized by local aggressiveness and low tendency to metastasize. The aim was reporting the clinical case of a patient with right multicystic ameloblastoma treated through hemimandibulectomy. We presented a male patient aged 44 years, who referred a volume increase of the jaw right side for around a year, accompanied also by other symptoms; he attended the Maxillofacial Surgery Service of the Main Military Hospital/High Institute of Luanda, in Angola. The image studies included panoramic radiography and computerized axial tomography the clinical pathological diagnosis was multicystic ameloblastoma. This kind of tumor requires an adequate diagnosis based on the clinical presentation, location, size, age and histological kind, therefore the importance of knowing the clinical and image characteristics, because the treatment is very difficult (AU).

Odontoma complejo en posición supernumeraria. Reporte de caso / Complex odontoma in supernumerary position. Case report

RESUMEN Fundamento: Los odontomas son entidades odontogénicas benignas mixtas, compuestas por una mezcla de células odontogénicas epiteliales y mesenquimatosas diferenciadas, las mismas pueden ser compuestas y complejas. Los hallazgos radiográficos de estos tumores en posiciones supernumerarias son raras menores al 1 %. Objetivo: Describir el caso clínico de un odontoma complejo infrecuente. Presentación de caso: Paciente femenina de 18 años con un trauma facial, que durante el diagnóstico imagenológico se le encontró una imagen anterosuperior de aspecto tumoral en posición supernumeraria, por lo que se decidió realizar la exéresis quirúrgica de la lesión después de finalizado el tratamiento del trauma. El diagnóstico clínico histopatológico fue de un odontoma complejo. Conclusiones: Se recomienda realizar las vistas imagenológicas tipo ortopantomografías o panorámicas a cada paciente que vaya a ser operado de cirugía bucal a fin de poder detectar de forma precoz cualquier alteración en la anatomía y de esta manera estudiar tanto el comportamiento de los odontomas como de otras lesiones intraóseas, lo que puede garantizar un tratamiento temprano y con ello un mejor pronóstico para el paciente.

ABSTRACT Background: Odontomas are mixed benign odontogenic entities, composed of a mixture of odontogenic epithelial and differentiated mesenchymal cells, they can be compound and complex. Radiographic findings of these tumors in supernumerary positions are rare, less than 1%. Objective: To describe the clinical case of a non-frequent complex odontoma. Case report: 18-year-old female patient with facial trauma, during the imaging diagnosis it was found an anterosuperior tumor image in supernumerary position, thus decided to perform the surgical excision of the lesion after the trauma treatment. The histopathological clinical diagnosis was a complex odontoma. Conclusions: It is recommended to perform standard panoramic radiograph imaging for each patient to be operated on oral surgery to detect any early anatomy alteration, so this way to study both, the behavior of odontomas as well as other intraosseous lesions, which can guarantee an early treatment and a better prognosis for the patient.

Tumor odontogénico adenomatoide en dos adolescentes / Adenomatoid odontogenic tumor in two adolescents

Se describen 2 casos clínicos de adolescentes de ambos sexos, quienes presentaron edemas en el lado izquierdo de la mandíbula con reabsorción dental y en la porción anterior del maxilar, respectivamente. La histopatología reveló una variante folicular intraósea del tumor odontogénico adenomatoide. El tratamiento quirúrgico empleado fue una enucleación con resultados satisfactorios.

Two cases reports of adolescents from both sexes are described, they presented edemas in the left side of the maxillary with dental reabsorption and in the anterior portion of the maxillary, respectively. The histopathology revealed an intraosseous folicular variety of the adenomatoid odontogenic tumor. The surgical treatment used was an enucleation with satisfactory results.

Conservative treatment of odontogenic fibromixoma in maxilla with 11-year follow-up: case report

Introduction: Odontogenic mixomas (OMs) are a locally infiltrating slow-growing intraosseous nonmetastasizing tumors of the maxilla and the mandible that have the potential for bone des-truction and cortical expansion, showing high recurrence rates. Their frequency varies around the world, accounting for 3-20% of all odontogenic tumors, ranking third among odontogenic tumors. They predominantly affect young adults, but may occur in various age groups. Report: A 37-year-old female patient who in August 2005 sought treatment at the Maxillofacial Dental Unit at Hospital Higueras, Talcahuano, Chile, for a left maxillary bone lesion. An increase in vo-lume was observed in the left maxillary region in the clinical analysis of the oral cavity. The neo-plasm was sessile and painless, measuring approximately 3 cm, with a greater diameter in the vestibule, firm on palpation and without signs of gangliopathy. Computed cone beam tomogra-phy imaging showed an extensive infiltrating osteolytic lesion in the left maxillary sinus, with noinvolvement of the orbital bone structure. Analysis of incisional biopsy yielded the diagnosis ofOdontogenic Fibromixoma. It was proposed to perform the conservative treatment of the lesion,consisting of enucleation and surgical curettage, obtaining excellent postoperative results and absence of relapse after 11-year follow-up. Conclusion: The present case report provides eviden-ce that supports the conservative surgical approach for the treatment of odontogenic myxomas, which contributes to a better postoperative quality of life for the patient.

Fibromixoma Odontogénico Agresivo en Maxila: Abordaje Quirúrgico / Aggressive Odontogenic Fibromixoma in Maxilla: Surgical Approach

RESUMEN: El fibromixoma odontogénico (FM) es una infrecuente lesión benigna que muestra un comportamiento invasivo. Considerada una variante del mixoma odontogénico, presenta un origen mesenquimal controvertido y ligera predilección por el sexo femenino. La lesión está asociada a zonas con estructuras dentales adyacentes, siendo su localización más frecuente la región mandibular posterior. El objetivo de este trabajo fue mostrar un caso agresivo de FM en una paciente, localizado en la zona posterior de maxila, destacando su abordaje quirúrgico. Se reporta un caso de una mujer de 52 años, la cual acudió a la consulta por presentar una masa indolora, firme a la palpación en el lado derecho de la maxila. Radiográficamente se observaba como una imagen radiopaca, de márgenes mal definidos que se extendía en el seno maxilar ipsilateral; la tomografía computarizada pudo evidenciar la expansión de las paredes del antro y la fosa nasal, con compromiso del cigomático y el piso de órbita. Se realizó biopsia incisional y el diagnóstico histopatológico fue de FM. El tratamiento de elección consistió en la resección en bloque, mediante abordaje Weber-Fergusson, acompañada de reconstrucción con placa y malla de titanio para garantizar la suspensión del globo ocular; un nuevo estudio histopatológico, confirmó el diagnóstico inicial. Al año del procedimiento quirúrgico no se evidenció recidiva, observando que el material de reconstrucción mantiene su posición, proporcionado estética y funcionabilidad a la paciente.

ABSTRACT: Odontogenic fibromyxoma (FM) is an infrequent benign lesion that shows with invasive characteristics. Considered a variant of the odontogenic myxoma, it presents a controversial mesenchymal origin and is somewhat more frequent in women. The lesion is associated with areas with adjacent dental structures, with its most frequent location in the posterior mandibular region. The objective of this study was to show an aggressive case of FM in a female, located in the posterior area of the maxilla, emphasizing its surgical approach. A case of a 52-year-old woman, who came to the clinic because of a painless, firm mass on the right side of the maxilla. Radiographically, it was seen as a radiopaque image, with poorly defined margins extending in the ipsilateral maxillary sinus; computed tomography showed the expansion of the walls of the antrum and the nasal cavity, with zygomatic compromise and the orbital floor. An incisional biopsy was performed and the histopathological diagnosis was FM. The treatment of choice consisted of block resection, using a WeberFerguson approach, along with reconstruction with a titanium plaque and mesh to guarantee suspension of the eyeball; a new histopathological study, confirmed the initial diagnosis. One year after the surgical procedure, there is no recurrence, and the reconstruction material maintains its position, providing aesthetic and functionality to the patient.

Hybrid lesion formed by a complex odontoma and dentigerous cyst: radiographic and histomorphological findings: a case report

Hybrid lesions of the oral cavity are infrequent and share characteristics with a number of other pathologies. both odontomas and dentigerous cysts are of odontogenic origin, but their simultaneous occurrence is rare and scarce. clinical and radiographic examinations are not conclusive, making their identification difficult, while histopathological studies can reveal their defining characteristics. the aim of this report was to describe the radiographic and histomorphological findings of a hybrid lesion formed by a complex odontoma and a dentigerous cyst, affecting the mandible of a 22-year-old man, from Cartagena, Colombia, who had no relevant medical history, and no symptoms or discomfort in the affected area.

Clear cell odontogenic carcinoma of the mandible: a treatment strategy

Abstract Clear cell odontogenic carcinoma (CCOC) is a rare odontogenic tumor of the jaws, histologically characterized by the presence of agglomerates of cells with eosinophilic cytoplasm. The patient, a 62-year-old Caucasian woman, presented an intraosseous lesion in the mandibular symphysis. A clinical examination revealed a discrete volumetric increase with a hard consistency, palpable to extraoral and intraoral examinations. Imaging studies revealed an extensive radiolucent area, without defined limits, extending from the region of the right second premolar to the left canine. Incisional biopsy analysis indicated a diagnosis of CCOC. The treatment proposed was segmental resection of the mandible with a safety margin. After six months without recurrence, definitive mandibular reconstruction was performed using an iliac crest graft, followed by rehabilitation with implant-supported denture after five months. After three years of post-resection follow-up, the patient has shown no evidence of recurrence or metastasis. She continues to be under follow-up. To conclude, CCOC must be considered a malignant tumor with aggressive behavior. Previous studies have shown that resection with free margins is a treatment with a lower rate of recurrence. Nevertheless, long-term follow-up is necessary for such patients.

Fibroma odontogénico periférico: reporte de un caso / Peripheral odontogenic fibroma: case report

El Fibroma Odontogénico Periférico fue definido por la OMS en el año 2005 como una neoplasia benigna rara constituida por tejido fibroso maduro y una cantidad variable de epitelio odontogénico inactivo. Dada su presentación clínica, localización y baja prevalencia suele ser mal diagnosticado como una lesión reaccional. Se presenta un caso clínico de fibroma odontogénico periférico tratado mediante remoción quirúrgica y se realiza una revisión de la bibliografía respecto a la patología con el propósito de esclarecer algunos aspectos de esta lesión, además de incluirla dentro de los posibles diagnósticos diferenciales de lesiones reaccionales gingivales. El objetivo del siguiente artículo es presentar un caso clínico de FOP tratado mediante remoción quirúrgica y aportar en el diagnóstico diferencial de las lesiones reaccionales gingivales.

Peripheral odontogenic fibroma was described by the World Health Organization (WHO) in 2005, as a rare benign tumor containing mature fibrous connective tissue with a varying amount of inactive odontogenic epithelium. Though its clinical presentation, localization and low prevalence, it tends to be misdiagnosed as a reactive lesion. We present a case report of a Peripheral Odontogenic Fibroma treated by surgical resection and a narrative review of the literature with the purpose of clarifying different aspects of this lesion besides considering it as a possible differential diagnosis of reactive gingival lesions. The purpose of this article is to present a case report of peripheral odontogenic fibroma treated by surgical resection. Also to contribute to the differential diagnosis of gingival reactive lesions.

Ameloblastic Fibrosarcoma: A Case Report and Literature Review

Here is described a case of ameloblastic fibrosarcoma (AFS) affecting the posterior mandible of a woman who was treated surgically and recovered without signs of recurrence or metastasis after 12 years of follow-up. Tumor sections were immunostained for cell cycle, epithelial and mesenchymal markers. Immunohistochemical analysis evidenced high Ki-67 positivity in stromal cells (mean of 20.9 cells/High power field). Epithelial cells displayed strong positivity for p53, p63 and cytokeratin 19. In addition to the case report, a systematic review of current knowledge is presented on the AFS’s clinical-demographic features and prognostic factors. Based on the review, 88/99 cases were diagnosed as AFS, 9/99 as ameloblastic fibro-odontosarcoma and 2/99 as ameloblastic fibrodentinosarcoma. All these lesions displayed very similar clinical-demographic and prognostic features. Moreover, the review provided evidence that first treatment, regional metastasis, distant metastasis and local recurrence were significant prognostic values for malignant odontogenic mesenchymal lesions. Based on the findings, segregation among ameloblastic fibrosarcoma, ameloblastic fibrodentinosarcoma and ameloblastic fibro-odontosarcoma seems illogical, considering all these lesions have similar predilections and outcomes.

Resumo Aqui é descrito um caso de fibrossarcoma ameloblástico afetando região posterior da mandíbula de uma mulher. Após o tratamento, a paciente ficou livre da doença durante os 12 anos de acompanhamento. Foi realizado imunohistoquimica para marcadores epiteliais, mesenquimais e do ciclo celular. Além disso, uma revisão sistemática de literatura também foi realizada, na tentativa de descobrir as características clínico-demográficas e fatores prognósticos da lesão. 88/99 casos foram diagnosticados como fibrossarcoma ameloblastico, 9/99 como fibro-odontosarcoma ameloblastico e 2/99 como fibrodentinosarcoma ameloblastico. Todas estas lesões exibem características clínico-demográficas e prognósticos muito semelhantes. Além disso, esta revisão forneceu evidências de que primeiro tratamento, metástases regionais, metástases à distância e recorrência local são valores prognósticos significativos para lesões odontogênicas mesenquimais malignas. A análise imunohistoquímica demonstrou elevada marcação positiva em células do estroma para Ki-67 (média de 20,9 células /HPF). As células epiteliais exibiram forte marcação para p53, p63 e citoqueratina 19. A segregação entre fibrosarcoma ameloblastico, fibrodentinosarcoma ameloblastico e fibro-odontosarcoma ameloblastico é ilógica, uma vez que todas essas lesões têm predileções e resultados semelhantes.

Application of endoscopy to treat mandibular keratocystic odontogenic tumors

The aim of this study was to evaluate the feasibility of endoscopy to remove keratocystic odontogenic tumors (KCOTs) with virtual 3D mandibular images. Fifteen patients (mean age, 40.27±14.58 years) who underwent endoscopic mandibular KCOT enucleation between May 2009 and October 2009 were included. Virtual 3D mandibular reconstructions derived from computed tomography (CT) imaging were generated for all patients. Recurrence and pathological fracture were evaluated as the primary outcome variables at 1 and 12 months after operation. Secondary infection and inferior alveolar nerve injury were evaluated as the secondary outcome variables at 1 and 6 months after operation. None of the 15 patients exhibited signs of recurrence or pathological fracture after operation. During long-term follow-up, no symptoms of inferior alveolar nerve injury or secondary infection were observed and no signs of recurrence were found in any of the patients. Endoscopy helps surgeons to remove mandibular KCOTs with small incisions. Moreover, endoscopy can provide clear and magnified views and help to avoid damage to the inferior alveolar neurovascular bundle. Therefore, under the support of preoperative virtual 3D mandibular images, the application of endoscopy to remove the tumors should be considered to be a treatment option for KCOTs.

Reclassification and treatment of odontogenic keratocysts: A cohort study

Abstract: The odontogenic keratocyst (OKC) is a recurrent cyst that has been recently reclassified from an odontogenic tumor to an odontogenic cyst. The aim of the present study was to investigate its treatment and address issues related to its association with nevoid basal cell carcinoma syndrome (NBCCS). Lesions from the cohort of patients included in the present study consisted of 40 OKCs, of which 27 lesions were treated by enucleation (GE) and 13 underwent decompression (GD). Complementary treatment occurred in 38 (95%) lesions, of which 10 underwent isolated peripheral ostectomy (GO) and 28 underwent peripheral ostectomy combined with Carnoy's solution (GC). Thirteen lesions were associated with NBCCS (GS), while the others (n=27) were non-syndromic lesions (GnS). The recurrence-free periods (RFP) in the sample groups were compared using the Kaplan-Meier function and log-rank test at a significance level of 5% (p < 0.05) and were used to calculate the cumulative risk of recurrence (CRR) in each postoperative year. During the follow-up period, which had a mean of 43.5 months (range: 12-102 months), six (15%) recurrences were diagnosed. There was no significant difference among the RFP for the compared groups (p > 0.05) or increased CRR for the decompression (15.4%) over five years. Application of Carnoy's solution did not increase the efficacy of the peripheral ostectomy, but was related to a CRR of 0% for the syndromic lesions over five years. Therefore, 1) decompression did not increase the recurrence risk; 2) peripheral ostectomy demonstrated a similar efficacy as the combination with Carnoy's solution; 3) the association of NBCCS did not seem to significantly influence OKC recurrence; and 4) syndromic lesions seem to behave in the same manner as non-syndromic lesions when submitted to complementary treatments.

O papel do cirurgião plástico na Síndrome de Gorlin / The role of the plastic surgeon in the treatment of Gorlin syndrome

Introdução: A síndrome de Gorlin ou síndrome do nevo carcinoma basocelular é uma doença multissistêmica infrequente, com um potencial de desenvolvimento de anormalidades de amplo espectro, como também de desenvolvimento de outras neoplasias. A mesma é autossômica dominante, com alta penetrância e grande variabilidade de expressão, manifesta-se em todos os grupos étnicos, sendo mais prevalente em caucasianos, e com relação entre os sexos de 1:1. Objetivo: Discorrer sobre esta afecção pouco comentada em nosso meio e que pode estar sendo subdiagnosticada e subtratada tanto pelo cirurgião plástico como pelos demais profissionais supostamente envolvidos. Método: Realizada revisão da literatura selecionando artigos sobre síndrome de Gorlin, no banco de dados da Medline/Pubmed de 2009-2013, e descrição da casuística do serviço do Hospital das Clínicas de Ribeirão Preto - USP. Conclusão: A síndrome de Gorlin é uma síndrome multissistêmica, com um amplo espectro de manifestações e grande potencial de mutilação relacionada principalmente ao tratamento de suas três principais alterações/ características. O cirurgião plástico desempenha papel importante na sua detecção e pode colaborar no tratamento abrangente com seguimento adequado aos seus portadores.

Introduction: Gorlin syndrome or nevoid basal cell carcinoma syndrome is a rare multisystemic disease with a potential to cause a broad spectrum of abnormalities and other cancers. It is an autosomal dominant disease with a high penetrance and large variability of expression, manifesting in all ethnic groups but more prevalent in Caucasians, and presenting at a sex ratio of 1:1. Objective: The aim of this study was to discuss Gorlin syndrome, which is little commented on in the literature , and is possibly being underdiagnosed and undertreated by plastic surgeons and other professionals. Method: A literature review was done by selecting articles about Gorlin syndrome from the Medline/PubMed database from 2009 to 2013, and a case-by-case description from the records of the

Tumor odontogênico adenomatoide folicular em maxila: relato de caso / Follicular adenomatoid odontogenic tumor in maxilla: case report

Tumor odontogênico adenomatoide (TOA) é uma lesão benigna incomum de origem odontogênica, caracterizado pelo crescimento lento, progressivo, indolor, de consistência firme, cujo tamanho, normalmente não atinge grandes proporções. Há predileção pela região anterior de maxila e o envolvimento de um dente impactado; geralmente o canino, é recorrente, caracterizando a variante folicular. O TOA apresenta três variantes: folicular, extrafolicular e periférica, que não se distinguem microscopicamente, porém são diferenciadas com achados clínicos ou imaginológicos. O presente trabalho descreve um caso de tumor odontogênico adenomatoide folicular, presente em maxila tratado por enucleação e curetagem. O paciente encontra-se em acompanhamento pós-cirúrgico de 30 meses, sem quaisquer sinais clínicos e radiográficos de recidivas da lesão... (AU)

Adenomatoid odontogenic tumor (AOT) is an uncommon benign lesion of odontogenic origin, characterized by slow growth, progressive painless, firm consistency, with size that normally does not reach large proportions. There is a predilection for the anterior maxilla and the involvement of an impacted tooth, usually the canine, is recurrent, featuring follicular variant. The TOA have three variants: follicular, extrafollicular and peripheral, which are not distinguishable microscopically, but clinically or imaging. This paperdescribes a case of follicular adenomatoid odontogenic tumor present in the maxilla, treated by enucleation and curettage with 30 months follow-up without clinical and radiographic signs of injury recurrence... (AU)

Ameloblastic Fibrodentinoma: A 12 Years follow-up of a Rare Entity.

Ameloblastic fibrodentinoma (AFD), according to the WHO is a neoplasm similar to ameloblastic fibroma, but also showing inductive changes that lead to the formation of dentine. AFD is a very rare odontogenic mixed tumor and only <40 cases have been reported so far. The origin, like other mixed odontogenic tumors is from the odontogenic apparatus. Two schools of thought exist, one to consider it as a variant of ameloblastic fibroodontoma and the other categorize it as a separate entity. An AFD in an 1½-year-old male patient with 12-year follow-up after treatment is presented.

Keratocystic odontogenic tumor: clinicopathological aspects and treatment / Tumor odontogénico queratoquístico: aspectos clínico-patológicos y tratamiento

The keratocystic odontogenic tumor is a benign intraosseous neoplasm derived from remnants of the dental lamina and it occurs with high frequency. Regarding histological characteristics, it has a high recurrence rate which is one of the main therapeutic problems. Also, it presents high local aggressiveness, expressed in cortical expansion, delayed eruption and displacement of teeth, blood vessels and nerves. At present, there are various treatments, being ideal the one which presents the lowest risk of recurrence with low morbidity for the patient. In this review, the main histopathological, clinical and therapeutic aspects of this oral pathology are discussed.

El tumor odontogénico queratoquístico es una neoplasia intraósea benigna que deriva de restos de la lámina dental, y que se presenta con alta frecuencia. Sus características histológicas le confieren una elevada tasa de recidiva, siendo este uno de sus principales problemas terapéuticos. Presenta además una considerable agresividad local, la cual se expresa con la expansión de corticales óseas, retardo en la erupción y desplazamiento de dientes, vasos sanguíneos y nervios. En la actualidad existen diversos tratamientos, siendo el ideal aquel que presente el menor riesgo de recidiva con una baja morbilidad para el paciente. En la presente revisión se discuten los principales aspectos histopatológicos, clínicos y terapéuticos de esta patología oral.

Tumor odontogénico queratoquístico: revisión de la literatura a propósito de un caso clínico / Keratocystic odontogenic tumor: a review of the literature in reference to a clinical case

El Tumor odontogénico queratoquístico es una entidad benigna de prevalencia relativamente alta que surge desde los remanentes de la lámina dental, el cual tiene un potencial comportamiento agresivo y alta recurrencia. Este tiende a crecer lentamente dentro del canal medular en sentido anteroposterior transformándose en una gran lesión sin causar una expansión obvia. Esta revisión describe la clínica, imagenología y tratamientos actuales del Tumor Odontogénico Queratoquístico a propósito de un paciente de sexo masculino 30 años diagnosticado con esta entidad.

Keratocystic Odontogenic tumor is a benign entity with relatively high prevalence that arises from remains of dental lamina. It has a potentially aggressive behaviour, high recurrence and anteroposterior slow growth in the medullar canal, which can become large lesion without obvious expansion. This review describes clinical, imagenological and current treatments of Keratocystic Odontogenic Tumor in 30- year-old male patient diagnosed with this entity.

Peripheral fibroma obstructing the eruption pathway.

Reactive hyperplasias comprise a group of fibrous connective tissue lesions that commonly occur in oral mucosa secondary to injury. Peripheral fibroma is also a type of reactive hyperplasia. Peripheral fibroma is a reactive hyperplastic mass that occurs on the gingiva and is derived from connective tissue of the submucosa or periodontal ligament. It may occur at any age, although it does have a predilection for young adults. Females develop these lesions more commonly than do males. Here, we are presenting a case report of a child who is 6 years old and presented to us with a swelling in the lower anterior region which was providing discomfort to the child and also was obstructing the eruption pathway of the permanent central incisor in the region. The lesion was surgically excised.