Los odontomas y sus implicancias / Odontomas and their implications

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)

Controversies in Odontogenic Tumours: Review.

Odontogenic tumours are lesions that occur solely within the oral cavity and are so named because of their origin from the odontogenic (i.e. tooth-forming) apparatus. Odontogenic tumours comprise a variety of lesions ranging from non-neoplastic tissue proliferations to benign or malignant neoplasms. However, controversies exist regarding the pathogenesis, categorisation and clinical and histological variations of these tumours. The recent 2017 World Health Organization classification of odontogenic tumours included new entities such as primordial odontogenic tumours, sclerosing odontogenic carcinomas and odontogenic carcinosarcomas, while eliminating several previously included entities like keratocystic odontogenic tumours and calcifying cystic odonogenic tumours. The aim of the present review article was to discuss controversies and recent concepts regarding odontogenic tumours so as to increase understanding of these lesions.

Odontoma compuesto: revisión de la literatura y reporte de un caso con 40 dentículos / Compound odontoma: a review of the literature and report of a case involving 40 denticles

El odontoma compuesto es un tumor benigno odontogénico conformadopor varios dentículos o dientes rudimentarios los cuales se encuentran conformados de tejido dental organizado. Su etiología no está biendefi nida pero se atribuye a traumatismos durante la primera dentición, así como a procesos infl amatorios o infecciosos, anomalías hereditarias o alteraciones en el gen de control del desarrollo dentario. Su presencia se encuentra entre los tres tumores odontogénicos más frecuentes, en diferente orden según el autor que se consulte. Está relacionado por logeneral con una alteración en la erupción o malposición dental. Tiene predilección en hueso maxilar, frecuentemente asintomáticos, se caracterizan por un crecimiento lento, diagnosticándose de forma casualmediante exámenes radiográfi cos de rutina entre la segunda y terceradécada de la vida. En este estudio se presenta el caso de un pacientefemenino de 14 años de edad, con presencia de un odontoma compuestode 40 dentículos, en la región parasinfi siaria izquierda, tratado medianteenucleación, y colocación de injerto óseo.

The compound odontoma is a benign odontogenic tumor composed ofseveral denticles or rudimentary teeth made up of organized dentaltissue. Its etiology is not well defi ned but is attributed to trauma duringthe fi rst dentition, as well as to infl ammatory or infectious processes, inherited abnormalities, odontoblastic hyperactivity or alterations in the gene that controls tooth development. It is among the 3 mostcommon odontogenic tumors, though its ranking among these varies depending on the author consulted. It is usually associated with analteration in the eruption or malposition of teeth. It has a predilection for the maxillary bone, and is often slow-growing and asymptomatic. Odontomas are diagnosed incidentally during routine X-ray examinations of patients between the second and third decades of life. In this study, we present the case of a 14-year-old female patient with the presence of a compound odontoma comprised of 40 denticles inthe left parasymphyseal region, which is treated by enucleation andbone graft placement.

Campylorrhinus lateralis, Bilateral microphthalmia and odontoma temporalis in an Oldenburg Foal.

An Oldenburg colt with wry nose was autopsied after having lived for only 30 min. It presented cyanotic oral mucosae, underdeveloped eyes and a right-sided temporal osseous mass. The applicable nomenclature for the defects is discussed, and the potential etiopathogenesis is explored by describing the normal embryonic development of the affected body parts.

Odontomas: tratamiento quirúrgico / Odontomas: surgical treatment

Los odontomas son tumores benignos odontogénicos y de crecimiento lento, formados por células de naturaleza dentaria epiteliales y mesenquimales. La etiología de este tipo de lesión es desconocida, pero se asocian a causas de tipo traumático, procesos infecciosos, anomalías hereditarias e hiperactividad odontoblástica. Se presentan dos casos clínicos en donde podemos observar los diferentes tipos de odontomas existentes. Los mismos fueron tratados en el Servicio de Odontología del Hospital Materno Infantil de la Ciudad de Mar del Plata.

Fibroodontoma ameloblástico: revisión de la literatura y reporte de dos casos / Ameloblastic fibroodontoma

El fibroodontoma ameloblástico (FOA) es una neoplasia benigna poco frecuente, con crecimiento lento y expansivo. Se presentan dos casos diagnosticados por hallazgo durante un examen radiográfico efectuado por retraso de la erupción dentaria, en los que se aplicaron diferentes criterios de tratamiento quirúrgico. Se revisan las características clínicas y anatomopatológicas de esta rara entidad.(AU)

The Ameloblastic Fibroodontoma is an unfrequent benign neoplasma characterized by slow growth and swallowing. This report describes two cases diagnosed during a radiographicexam conducted by delayed tooth eruption. In these cases, different surgical treatments were applied, with satisfactory final results in both. The clinical and pathological features of thisrare entity are revised.(AU)

Fibroodontoma ameloblástico: revisión de la literatura y reporte de dos casos / Ameloblastic fibroodontoma

El fibroodontoma ameloblástico (FOA) es una neoplasia benigna poco frecuente, con crecimiento lento y expansivo. Se presentan dos casos diagnosticados por hallazgo durante un examen radiográfico efectuado por retraso de la erupción dentaria, en los que se aplicaron diferentes criterios de tratamiento quirúrgico. Se revisan las características clínicas y anatomopatológicas de esta rara entidad.

The Ameloblastic Fibroodontoma is an unfrequent benign neoplasma characterized by slow growth and swallowing. This report describes two cases diagnosed during a radiographicexam conducted by delayed tooth eruption. In these cases, different surgical treatments were applied, with satisfactory final results in both. The clinical and pathological features of thisrare entity are revised.

[Benign epithelial odontogenic tumors]. / Benigne epitheliale odontogene Tumoren.

The group of benign epithelial odontogenic tumors consists of the four member types of the ameloblastoma family (solid/multicystic, extraosseous/peripheral, desmoplastic, unicystic), squamous odontogenic tumors, calcifying odontogenic tumors, adenomatoid odontogenic tumors, and keratocystic odontogenic tumors, the former "keratocysts" that were recently reclassified by the World Health Organization and are now regarded as tumors. The latter are by far the most frequent tumors in this group, followed by solid/multicystic ameloblastoma. Although the etiology of these lesions is still unknown, a close relationship to normal tooth development is obvious, which is partially imitated by some tumors. Despite some similarities to each other, at least in part, the biological behavior of these lesions is quite different, as are treatment modalities. The diagnosis is essentially based on localization (intraosseous vs. extraosseous/peripheral) and histology, whereupon the correlation of histological findings with radiographic morphology may be of additional diagnostic value. Because of the range of variation, immunohistochemical investigations are not helpful in diagnosing a particular case.

[Benign "mixed" odontogenic tumors]. / Benigne "gemischte" odontogene Tumoren.

Benign "mixed"odontogenic tumors consist of an epithelial and ectomesenchymal tumor component, distinguishing them from pure epithelial and pure ectomesenchymal odontogenic tumors. In addition, they may have the ability to produce dentin, enamel or cementum. Therefore, they can sometimes already be differentiated radiologically from epithelial odontogenic tumors. Some of the mixed odontogenic lesions are regarded as true tumors (ameloblastic fibroma, odontoameloblastoma, dentinogenic ghost cell tumor), while others are assumed to represent hamartomatous lesions (complex and compound odontoma, probably also ameloblastic fibrodentinoma and ameloblastic fibroodontoma). Preceded by keratocystic odontogenic tumor, complex and compound odontomas are the second most common odontogenic tumors, while other members of the "mixed" odontogenic tumor group are far less frequently diagnosed. Odontoameloblastoma and dentinogenic ghost cell tumors are locally aggressive lesions that require total resection. All other lesions of this group are treated by local excision. Since ameloblastic fibrosarcoma may evolve from ameloblastic fibroma, patients with ameloblastic fibroma should remain in long-term follow-up.

Fibroodontoma ameloblástico: FOA / Ameloblastic fibro-odontoma: AFO

El fibroodontoma ameloblástico es una lesión extremadamente rara que involucra tejidos duros dentarios (esmalte, dentina y cemento), aparece generalmente en una edad promedio entre los 12 y un límite que puede llegar alrededor de los 40 años de edad y posee una predilección por la zona de los molares y premolares de ambas arcadas, de igual forma en ambos sexos y con similar conducta biológica. Se presenta un caso clínico de una paciente de 23 años de edad con una gran lesión patológica, su tratamiento y evolución.

Fibroodontoma ameloblástico: FOA / Ameloblastic fibro-odontoma: AFO

El fibroodontoma ameloblástico es una lesión extremadamente rara que involucra tejidos duros dentarios (esmalte, dentina y cemento), aparece generalmente en una edad promedio entre los 12 y un límite que puede llegar alrededor de los 40 años de edad y posee una predilección por la zona de los molares y premolares de ambas arcadas, de igual forma en ambos sexos y con similar conducta biológica. Se presenta un caso clínico de una paciente de 23 años de edad con una gran lesión patológica, su tratamiento y evolución.(AU)

Ameloblastic fibroma and related lesions: a clinicopathologic study with reference to their nature and interrelationship.

BACKGROUND: Ameloblastic fibroma (AF) and related lesions constitute a group of lesions, which range in biologic behavior from true neoplasms to hamartomas. The aim of this study was to elucidate the nature and interrelationship of this group of lesions. METHODS: Clinical and pathological studies were undertaken retrospectively on 13 cases of AF and seven cases of ameloblastic fibro-odontoma (AFO). Thirty-three complex odontomas and 33 compound odontomas were also included for comparative purpose. Relevant follow-up data were recorded and the literature was reviewed. RESULTS: The majority of patients with AF (nine cases, 69.2%) were over the age of 22 years with frequent involvement (76.9%) of the posterior mandible. Tumors recurred in four of 11 patients with follow-up information and two recurrent tumors showed malignant transformation. There was no case in this series that could be designated as the so-called ameloblastic fibrodentinoma, apart from one recurrent AF in which further maturation to form only tubular dentin materials was identified. AFO tended to occur at a younger age group with an average of 9.6 years. Recurrence was noted in two of five patients with follow-up data and both recurrent lesions showed limited growth potential and further maturation into a complex odontoma. Significant differences were noted in the age and site distribution between the complex and the compound odontomas. CONCLUSION: Whilst the majority, if not all, of AFs are true neoplasms with a potential to recur and/or of malignant transformation, some, especially those occurred during childhood, could represent the primitive stage of a developing odontoma. Our data also suggests that some AFOs are hamartomatous in nature, representing a stage preceding the complex odontoma.

Odontoma compuesto complejo: un caso clínico / Compound complex odontoma: a clinical case

Los odontomas son tumores odontogénicos de hallazgo muy frecuente y son generalmente asintomáticos. Presentaremos un caso de un odontoma compuesto complejo en una mujer de 41 años de edad que provocó la retención de dos piezas dentarias. Un diagnóstico temprano de la lesión permite adoptar mejores medidas para un mejor pronóstico (AU)

Compound odontoma: a case study.

Odontomas are the most common odontogenic tumors and are usually incidental findings in radiographic examination. They are classified as either compound or complex. Both types are composed of enamel, dentin, cementum, and pulp tissues. Compound odontomas appear radiographically as rudimentary toothlets and can be diagnosed from radiographs alone, while complex odontomas appear as indistinguishable radiopaque masses and require resection for definitive diagnosis. They are frequently found in association with other abnormalities, and surgical excision is recommended for both types by most practitioners. The possibility of discovering lesions such as the odontoma supports the practice of recommending baseline radiographic surveys for all dental patients.

[Revision of the 1992 edition of the WHO histological typing of odontogenic tumors. A suggestion]. / Revision der WHO-Klassifikation odontogener Tumoren von 1992. Ein Vorschlag.

The WHO classification of odontogenic tumors (1992, OT) was revised. The following main changes were proposed: (1) OT are not only "related to" odontogenic tissues but are derived from these; (2) the stroma of the epithelial tumor group (1.1.1) is of a fibrous nature and does not contain any ectomesenchymal component; (3) subtypes of ameloblastomas have to be differentiated (intra-, extraosseous, desmoplastic, unicystic); (4) eponyms are no longer used in the revised classification; (5) the AOT is reclassified as an epithelial OT; (6) a neoplastic and non-neoplastic line of the ameloblastic fibroma and ameloblastic fibrodentinoma is proposed; (7) the calcifying ghost cell odontogenic tumor is included in the classification; (8) the simple and the WHO type of odontogenic fibroma are included in the classification; (9) the classification of malignant OT is adapted from Eversole (1999) with a few changes. In particular, ameloblastic carcinoma is differentiated from malignant ( metastasizing) ameloblastoma; (10) the term carcinoma in intraosseous (peripheral) ameloblastoma is introduced. Also, the malignant epithelial odontogenic ghost cell tumor is termed calcifying ghost cell odontogenic carcinoma; (11) the clear cell odontogenic tumor is termed clear cell odontogenic carcinoma; (12) the so-called pseudocysts are termed "cavities" (aneurysmal bone cavity, simple bone cavity, lingual and buccal mandibular bone cavity, focal marrow-containing jaw cavity).

A case of complex odontoma associated with an impacted lower deciduous second molar and analysis of the 107 odontomas.

OBJECTIVE: Odontoma is a comparatively common odontogenic tumor, and it may lead to interference with the eruption of its associated tooth. Odontomas are mostly associated with permanent teeth, and they are rarely associated with deciduous teeth. The purpose of this report is to analyze 107 odontomas and to present a case of complex odontoma associated with a lower deciduous second molar. SUBJECT AND METHODS: The 106 cases were analyzed with regard to the following parameters: age, gender, location, erupted teeth, congenital missing teeth, radiological features, histopathological features and prognosis. RESULTS: Of the 106 cases, 41 were complex odontoma, 62 were compound odontoma, and three were immature odontoma. Compound odontoma had a predilection for the anterior. Complex odontoma occurred more often at the mandible. CONCLUSION: Odontoma located above the tooth crown of lower deciduous molar did not behave clinically different from that associated with permanent tooth. An odontoma could be related with a supernumerary tooth or a missing tooth. If odontomas, which interfered with tooth eruption, were extirpated early, the impacted teeth would probably erupt normally and be normal in shape.