RESUMEN
El fibro-odontoma ameloblástico (FOA) es una neoplasia odontogénica benigna poco frecuente que afecta a los huesos maxilares. Posee un componente de tejido epitelial y ectomesénquima, por lo que hasta hace un tiempo era incluido dentro de la clasificación de tumores odontogénicos de origen mixto. Actualmente estas lesiones no están incorporadas en la última clasificación de los tumores odontogénicos y huesos maxilofaciales de la organización mundial de la salud y son consideradas como un odontoma en desarrollo. Clínicamente se presenta con mayor frecuencia en mandíbula y asociado a la falta de erupción de un diente. Presentamos el caso clínico de un niño de 6 años de edad que acudió a nuestro servicio maxilofacial por la no erupción de un diente temporal mandibular. El cuadro clínico y las investigaciones confirmaron la hipótesis diagnóstica de FOA con una impactación del segundo molar temporal inferior izquierdo hacia el margen basilar mandibular y el germen dentario del premolar por sobre la corona del diente retenido.
Ameloblastic fibro-odontoma (AFO) is a rare benign odontogenic neoplasm that affects the maxillary bones. It possesses both an epithelial and ectomesenchymal component, for which it was previously included in the classification of mixed odontogenic tumors. The AFO is currently not included in the latest classification of odontogenic and maxillofacial bone tumors, and is considered a developing odontoma. Clinically, it predominantly manifests in the mandible, in frequent association with the lack of eruption of a tooth. In this article, the authors present a case of a 6 year old boy with the query of an unerupted primary mandibular tooth. Both the clinical examination and the subsequent investigation confirmed the diagnostic hypothesis of an AFO with subsequent impaction of the primary left mandibular second molar, which was displaced against the base of the mandible, and the tooth germ for the left mandibular second premolar positionedover the crown of the retained tooth.
RESUMEN
Objetivo: Presentar el caso de una patología poco común como es el fibro-odontoma ameloblástico (FOA), su manejo interdisciplinario y su resolución quirúrgica. Caso clínico: En este reporte de caso describimos un FOA en una paciente de 10 años, ubicado en el cuerpo mandibular derecho, asociado a las raíces de molares temporales que generó la retención de premolares. Se realizó la enucleación completa de la lesión, exodoncia de los temporales asociados y se decidió mantener los dientes definitivos y esperar su erupción espontánea. Es importante considerar la posibilidad de mantener el diente retenido si este no dificulta la exéresis de la lesión, ya sea para su erupción espontánea o rescate ortodóntico, lo cual es posible observar en este caso en el que se aprecia una evolución intraósea favorable. Con respecto al seguimiento, se recomienda el control a largo plazo con el fin de controlar la erupción del órgano dentario o la aparición de posibles recidivas (AU)
Aim: To present a clinical case of a rare pathology, the ameloblastic fibro odontoma (AFO), its interdisciplinary management and its surgical resolution. Clinical case: In this case report we describe an AFO in a 10-years-old patient, localized in the right hand side of the body of the mandible, associated with the roots of temporary molars that generated the retention of the premolars. Complete enucleation of the lesion and the extraction of the associated temporary molars were performed. It was decided to keep the permanent teeth and to wait for their spontaneous eruption. It is important to consider the possibility of keeping the retained teeth if it does not hinder the excision of the lesion, either for its spontaneous eruption or orthodontic rescue, which is possible to see in this case, in which a favorable intraosseous evolution is appreciated. With regard to follow-up, long-term monitoring is recommended in order to control the eruption of the dental organ or the appearance of possible recurrences (AU)
Asunto(s)
Humanos , Femenino , Niño , Tumores Odontogénicos , Odontoma/cirugía , Facultades de Odontología , Extracción Dental , Diente Impactado , Diente Premolar , Biopsia , Chile , Técnicas Histológicas , Procedimientos Quirúrgicos Orales , Diente MolarRESUMEN
Resumen Actualmente los odontomas son los tumores odontogénicos más frecuentes. Son considerados hamartomas, compuestos por células epiteliales odontogénicas y mesenquimatosas diferenciadas, y muestra tejidos dentales en su estructura. Se presenta una revisión de la literatura seguido por un reporte de caso de un odontoma compuesto en el maxilar inferior de un paciente de 13 años asociado a la inclusión del segundo molar inferior derecho (4.7). Se realizó la exéresis del tumor y la correspondiente biopsia para confirmar el diagnóstico.
Abstract At present time odontomas are the most common odontogenic tumors. They are hamartomas, composed of epithelial odontogenic and mesenchymal cells, presenting dental tissue in their structure. A literature review followed by a case report are presented. The case report presents a compound odontoma in the inferior maxillary of a 13-year-old patient, associated with the inclusion of the second right inferior molar (4.7). The exeresis followed by the biopsy of the tumor were performed to confirm the clinical diagnosis.
Asunto(s)
Humanos , Masculino , Adolescente , Anomalías Dentarias/cirugía , Odontoma/diagnóstico , HondurasRESUMEN
Ameloblastic fibro-odontoma (AFO) is a mixed odontogenic tumor, which has an epithelial and mesenchymal component. It can be observed in imaging tests as a radiomixed lesion, with some authors claiming it represents only the predecessor of an odontoma. Epidemiologically, it appears between the second and third decade of life, predominantly in males and with a predilection for the posterior area of the mandible. This lesion presents a good prognosis and it responds well to enucleation by curettage with a low rate of recurrence. In the present article, two cases of ameloblastic fibro-odontoma in an unusual region of the maxilla are presented.
El Fibro-odontoma ameloblástico (FOA), es una lesión tumoral mixta de origen odontogénico, el cual tiene un componente epitelial y mesenquimático. En su imagenología se observa como una lesión radiomixta, debido a que algunos autores afirman que este no es más que el predecesor de un odontoma. Epidemiológicamente, se presenta entre la segunda y tercera década de la vida, preferencia por sexo masculino y predilección por el área posterior de la mandíbula. Es una lesión de buen pronóstico que responde bien a la enucleación por curetaje con baja tasa de recidiva. En el presente artículo, se presentan dos casos de fibro-odontoma ameloblástico en una región inusual de los maxilares.
Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Anomalías Dentarias/complicaciones , Neoplasias Maxilares/complicaciones , Odontoma/complicaciones , Radiografía Panorámica , Mandíbula/diagnóstico por imagenRESUMEN
Ameloblastic fibro-odontoma (AFO) is a benign, epithelial odontogenic tumor with odontogenic mesenchyme having the histologic characteristics of both ameloblastic fibroma and complex odontoma. This report describes the case of a 14-year-old girl with AFO on the right posterior mandibular region that mimics complex odontoma on incisional biopsy due to the presence of atypical dentin- and cementum-like areas. On histological examination, sections of excisional biopsy showed odontogenic epithelial islands with embryonic connective tissue and decalcified sections showed atypical dentin with dentinal tubules and islands of cementum. These features led to the diagnosis of AFO.
RESUMEN
La Organización Mundial de la Salud clasifica los odontomas como tumores odontogénicos benignos compuestos de epitelio odontogénico y ectomesénquima odontogénico con formación de tejido duro dental. Los odontomas, por definición, son lesiones habitualmente hamartomatosas que suelen encontrarse sobre dientes no erupcionados, compuestas de esmalte, dentina, pulpa y cemento en formas reconocibles de dientes (odontoma compuesto) o bien como una masa nudosa sólida (odontoma complejo). Algunos tumores constituyen una combinación de ambos tipos (es decir, no solo contienen estructuras múltiples de aspecto similar a un diente, sino también masas calcificadas de tejido dental dispuestas al azar). Estas lesiones se denominan odontomas complejos-compuestos. Otro tipo, el fibroodontoma ameloblástico, es un tumor infrecuente que contiene los componentes tisulares blandos del fibroma ameloblástico y los componentes de tejido duro del odontoma complejo (AU)
The World Health Organization classifies odontomas as a benign odontogenic tumor composed of odontogenic epithelium and odontogenic ectomesenchyma with dental hard tissue formation. Odontomas, by definition, are usually hamartomatous lesions, frequently found on unerupted teeth, composed of enamel, dentin, pulp and cement in recognizable forms of teeth (compound) or a solid knotty mass (complex). Some tumors constitute a combination of both types (i.e., they not only contain multiple structures similar in appearance to a tooth, but also calcified masses of dental tissue arranged at random). These lesions are called complex-compound odontomas. Another type, the ameloblastic fibro-odontoma, is an infrequent tumor that contains the soft tissue components of the ameloblastic fibroma and the hard tissue components of the complex odontoma (AU)
Asunto(s)
Humanos , Tumores Odontogénicos/clasificación , Odontoma/clasificación , Hamartoma , Extracción Dental , Diente Impactado , Diente no Erupcionado , Organización Mundial de la SaludRESUMEN
ABSTRACT: The appearance of mixed odontogenic tumors into the oral cavity is a rare event. It is considered that some mixed tumors are only a stage in the complete development of a hamartomatous formation such as ameloblastic fibroodontoma and odontoma. Both pathologies share in common cellular elements which at one point makes them indistinguishable from each other. We present the case of a 21 year old patient who showed a mandibular growth whose histological elements present characteristics of both pathologies. The treatment was surgical excision of the lesion. There were no complications or recurrences to periodic reevaluation.
RESUMEN: La aparición de tumores odontogénicos mixtos en la cavidad oral es un evento raro. Se considera que algunos tumores mixtos son solo una etapa en el desarrollo completo de una formación hamartomatosa como el fibro-odontoma ameloblástico y odontoma. Ambas patologías comparten elementos celulares comunes que en un punto los hacen indistinguibles entre sí. Presentamos el caso de un paciente de 21 años que mostró un crecimiento mandibular cuyos elementos histológicos presentan características de ambas patologías. El tratamiento fue la escisión quirúrgica de la lesión. No hubo complicaciones o recurrencias a la reevaluación periódica.
Asunto(s)
Humanos , Adulto Joven , Neoplasias Gingivales/patología , Odontoma/patología , Quiste Odontogénico Calcificado/patología , Neoplasias Gingivales/cirugía , Radiografía , Odontoma/cirugía , Quiste Odontogénico Calcificado/cirugía , FibroblastosRESUMEN
Ameloblastic fibro-odontoma (AFO) is an uncommon benign odontogenic tumor with histologic features similar to that of ameloblastic fibroma, but with inductive changes that lead to the formation of enamel and dentin. Among the odontogenic tumors, the incidence varies from 0.3% to 1.7%, reaching 4.6% when only the cases of children are considered. AFO presents as a painless swelling mostly in the posterior portion of the maxilla or mandible. Radiographs show the radiolucent area containing various amounts of radiopaque material of irregular size and form. This case report describes AFO affecting the 21-year-old woman. The lesion was surgically excised, and no recurrence was observed on follow-up.
RESUMEN
Ameloblastic fibro-odontoma (AFO) is a rare, benign epithelial mixed odontogenic tumor. It occurs as an intraosseous lesion, generally asymptomatic and more prevalent in children and adolescent. AFO is found on radiographic evaluation of patients with unerupted or impacted teeth in many cases. Histological examination reveals a fibrous soft tissue, islands of odontogenic epithelium and a disordered mixture of dental tissues. The treatment modality in most cases involves conservative surgery with enucleation. We present a case of 13-year-old boy with a missing right central incisor, mimicking-like odontoma on radiograph but proved to be AFO and treated with enucleation with preservation of impacted tooth. There was no recurrence after one year of follow-up. This report discusses the clinical, radiographical, histological features and surgical assessment to preserve the impacted tooth associated with AFO.
Asunto(s)
Adolescente , Ameloblastos/patología , Biopsia , Tejido Conectivo/patología , Diagnóstico Diferencial , Epitelio/patología , Fibroblastos/patología , Humanos , Incisivo/patología , Masculino , Neoplasias Maxilares/diagnóstico , Quiste Odontogénico Calcificado/diagnóstico , Tumores Odontogénicos/diagnóstico , Odontoma/diagnóstico , Diente Impactado/diagnósticoRESUMEN
Odontogenic tumors comprise a complex group of lesions of diverse histopathological types and clinical behavior. The group of mixed odontogenic tumors, which are also rare, is composed of proliferating odontogenic epithelium in a cellular ectomesenchyme resembling dental papilla. Ameloblastic fibrodentinoma is a rare benign odontogenic tumor. The present case report discusses this tumor composed of odontogenic epithelium and odontogenic mesenchyme with dentin or dentin like tissue. The present paper also throws light on various histological similarities and complexities which make the interpretation of these set of odontogenic tumors a diagnostic dilemma.
Asunto(s)
Dentina/patología , Diagnóstico Diferencial , Epitelio/patología , Humanos , Masculino , Neoplasias Maxilares/diagnóstico , Neoplasias Maxilares/patología , Células Madre Mesenquimatosas/patología , Persona de Mediana Edad , Tumores Odontogénicos/diagnóstico , Tumores Odontogénicos/patologíaRESUMEN
Odontomas are benign hamartomas which are often detected on routine radiographic examinations for other dental complaints. They are usually surgically removed but are rarely examined histopathologically. We report two cases with identical radiological features but different histopathological outcome, thus stressing the importance of histopathological examination of odontoma.
RESUMEN
We report an ameloblastic fibro-odontoma (AFO) presenting in the anterior mandible as a "bump on his gums" in a 22-month-old boy. An occlusal radiograph revealed a well-circumscribed radiolucency with scattered radiopaque foci. The tumor was enucleated under general anesthesia. The histologic findings were characteristic of an AFO, a mixed odontogenic tumor most common in the posterior jaws, primarily affecting individuals with an average age of 10 years. The clinical presentation, microscopic findings, differential diagnoses, and treatment are discussed.
Asunto(s)
Biopsia , Diagnóstico Diferencial , Estudios de Seguimiento , Neoplasias Gingivales/diagnóstico , Humanos , Lactante , Masculino , Neoplasias Mandibulares/diagnóstico , Odontoma/diagnósticoRESUMEN
Ameloblastic fibro-odontoma(AFO) is a rare mixed odontogenic tumor. It is composed of connective tissue characteristic of an ameloblastic fibroma and calcified tissue as a complex or compound odontoma. AFO usually presents itself as an asymptomatic swelling of jaw or failure of tooth eruption. The lesion usually occurs in individual less than 30 years old. The differential diagnosis of this tumor includes odontoma, ameloblastoma, and ameloblastic fibroma. This report describes an ameloblastic fibro-odontoma occurring in maxilla of sixteen-year-old female. The lesion was treated by surgical enucleation and curettage without extraction of the involved canine(#23). This patient has shown no sign of recurrence during postoperative 34 months. So we report our case with review of literatures.
Asunto(s)
Adulto , Femenino , Humanos , Ameloblastoma , Ameloblastos , Tejido Conectivo , Legrado , Diagnóstico Diferencial , Fibroma , Maxilares , Maxilar , Tumores Odontogénicos , Odontoma , Recurrencia , Erupción DentalRESUMEN
Ameloblastic fibro-odontoma is a rare benign mixed odontogenic tumor with histologic characteristics of ameloblastic fibroma and complex odontoma. As with ameloblastic fibroma, it may be asymptomatic or found because of painless swelling and delayed eruption of associated tooth. This report presents a case of ameloblastic fibro-odontoma in the posterior mandible of a 14-year-old girl and analyses its clinical features and radiographic features on plain X-ray film and CT images.
Asunto(s)
Adolescente , Femenino , Humanos , Ameloblastos , Fibroma , Mandíbula , Tumores Odontogénicos , Odontoma , Diente , Película para Rayos XRESUMEN
Ameloblastic fibro-odontoma is an extremely rare odontogenic tumor composed of proliferating ectodermal and mesenchymal components of odontogenic tissue, containing hard tooth structure. It occurs predominantly in children and young adults. The mandibular molarramus area is the most frequently observed location, presenting radiographically as a well-circumscribed and radiolucent-radiopaque tumor. A case involving a 24-year-old woman presenting with a large ameloblastic fibro-odontoma of the posterior mandible is reported. This case is of radiologic interest because two distinct calcification patterns were observed.