Akademik Veri Yönetim Sistemi
XVIth European Congress of DentoMaxilloFacial Radiology, Luzern, İsviçre, 13 - 16 Haziran 2018, ss.184-185, (Özet Bildiri)
Case Report
A21-year old female patient attended to our clinic with a complaint of teeth mobility and pain. The subject had no significant medical history and did not reported any oral trauma or infection. Clinical examination revealed loss of the teeth 14, 34, 36, 46 and persisted tooth 63 with mobility. There was pain on vertical percussion on the tooth 25 and did not show any sensitivity to electrical vitality test. Patient underwent panoramic radiographic evaluation and radiography revealed impacted maxillary left canine associated with a well-defined mixed lesion. Cone beam computed tomography (CBCT) imaging performed to evaluate the extension of the lesion and the anatomical topography. CBCT examination revealed a corticated, well defined, 81x10x10 mm rounded-shaped mixed lesion in relation with impacted tooth 23. Expansion of the bone is not detected. Tooth 25 underwent root canal treatment. Impacted canine, persistant primary canine and the lesion was excised surgically. Histopathologically examination at HEX200 revealed enamel and dentin like structures adjacent to odontogenic epitel. Follow-up was conducted after two months by a periapical radiograph.
Discussion
Odontoma is a term used for describing benign lesions of odontogenic origin and a mixed composition of dental epithelial and mesenchymal cells. Odontomas can be regarded as hamartomas or malformations rather than true neoplasm. Odontomas are rarely lead to pathological development of a cyst, such as calcifying odontogenic cyst or a dentigerous cyst. According to World Health Organization, being updated in 2005, odontomas can be classified in two types, compaund and complex odontomas. An impacted tooth is often associated with odontomas. In our case, the lesion was associated with impacted tooth 23. The etiology of odontomas is unknown, but trauma, inflammatory and infectious processes or heredity can be the cause. Odontomas are composed of enamel, dentin, cement and in some cases pulp tissue histologically. These dental tissue may appear normal but with deficient structural arrangement. In our case, enamel, dentin and odontogenic epithelium was seen. Complex odontomas are ussually asymptomati. In our case, there was no clinical sign of lesion but the mobility of persisted tooth 63. Surgical removal of the odontomas represent the best therapeutic option.
Conclussion
Despite odontomas rarely lead to pathological development of a cyst, it is important to diagnose and plan proper treatment for the patients. CBCT is a valuable method for evaluating the lesion and its relation to the adjacent structures.