Odontogenic tumors: clinical and pathology study of 238 cases

SummaryOdontogenic tumors are neoplasms that develops exclusively in the gnathic bones; they originate from odontogenic tissues, by epithelial or mesenchymal proliferation, or both.AimTo evaluate the incidence of odontogenic tumors in a specific institution, and to compare these findings with other studies in the literature.Study formatA cross-sectional cohort retrospective study.Material and methodThe sample was obtained from the files of patients with odontogenic tumors diagnosed between January 1992 and March 2007 (15 years). Cases in which the diagnosis could be adapted to the new World Health Organization (WHO) of 2005 were included. Data such as gender, age, anatomical site, histological type and symptomatology were analyzed.ResultsOdontogenic tumors were 4.76% of all biopsied lesions within the studied period. The mean age was 30.7 years; 57% of the patients were male. The keratocystic odontogenic tumor was the most prevalent histological type (30%), followed by the ameloblastoma (23,7%). The rate of asymptomatic cases was 75.7%.ConclusionOdontogenic tumors occurred more frequently in females, in the second and third decades of life, and more commonly in the mandible; most cases were asymptomatic

Spontaneous Bisphosphonate-related Osteonecrosis Associated with a Tooth that Had a Necrotic Pulp: A Case Report

This study reports the endodontic treatment performed in a patient who presented with spontaneous bone exposure in the mandible while using intravenous bisphosphonate medication (ZometaÒ, Novartis Pharmaceuticals Co., Basel, Switzerland). A 63-year-old female patient was referred to a private dental clinic at Fortaleza, Brazil. The patient reported that one year before, she had undergone chemotherapy for the treatment of lung cancer and associated bone metastasis. Among the medications administered was the zolendronic acid, with dosage of 4 mg every 21 days. In the oral exam, the presence of extensive bone exposure was observed in the lingual region near tooth 37. The patient reported severe pain on palpation in the region; in the pulpal sensitivity test with cold stimulus, there was an absence of pain, characteristic of pulp necrosis. Radiographically, no periapical lesion was observed. Thus, endodontic treatment was performed, and instrumentation with Reciproc R25 files in the mesial root canals and R40 in the distal canal was done, alongside with abundant 2.5% sodium hypochlorite irrigation. Interappointment medication with calcium hydroxide was maintained for 15 days. In the second session, there was the spontaneous detachment of the exposed cortical bone fragment. The root canals were filled with gutta-percha and Endosequence BC Sealer cement. After two years, complete tissue repair was observed, and the patient presented with normal periapical tissues and the tooth in masticatory function.   It may be concluded that a possible relationship between pulp and periapical infections and osteonecrosis exists in patients who use bisphosphonates

Horizontal Maxillary Osteotomy Approach for Resection of Juvenile Nasopharyngeal Angiofibroma

Juvenile angiofibroma is a benign fibroangiomatous tumor of relatively rare occurrence, developing most frequently in male adolescents. It has local characteristics of aggressiveness and expansion. The treatment of choice is surgical excision. In this article, the advantages and disadvantages of the surgical technique using the Le Fort I osteotomy are described, and the literature correlated with 2 case reports

ESTUDIO CLÍNICO PATOLÓGICO DE ODONTOMAS EN UNA MUESTRA DE LA POBLACIÓN BRASILERA EN UN PERÍODO DE 15 AÑOS

Los odontomas son considerados el tipo más común de tumores odontogénicos, generalmente observados en exámenes radiográficos, siendo esa, la base de diagnóstico de muchos estudios. Elobjetivo del presente trabajo fue la realización de un análisis retrospectivo descriptivo en el periodo comprendido entre enero de 1992 a enero de 2007 a partir de estudios anatómico-patológicos. Fueronevaluados 238 casos de tumores odontogénicos, de los cuales 44% eran odontomas. Los resultados demostraron que 68,52% de los casos ocurrieron en el género femenino, siendo la 1ª y 2ª décadas de vida las más prevalentes (46,3%). La mayoría de los casos (81,48%) se mostró asintomático, con unadiscreta predilección por el maxilar (57,41%). El tipo compuesto fue más frecuente que el complejo, con53,7% y 46,3% de los casos, respectivamente. El presente estudio fue basado en diagnóstico anatomopatológico, diferenciándose así de estudios ya publicados, que se basan en análisis radiográficos. A pesarde las diferencias entre los estudios sobre género, edad, extensión, localización y síntomas, variassimilitudes fueron observadas. Nuevos estudios retrospectivos en diferentes poblaciones son necesarios para promover una mejor comprensión de los odontomas.Abstract Odontomas are considered the most common type of odontogenic tumors, usually observed inradiographic examination, which is the basis of diagnosis in many studies. The authors performed adescriptive retrospective analysis in the period from January 1992 to January 2007 from the PernambucoUniversity Oral Pathology Laboratory's records. Two hundred and thirty eight cases of odontogenic tumors were registered, in which 44% were odontomas. Results showed that 68.52% of the cases werefemale, with 1st and 2nd decades of life being most prevalent (46.3%). The majority of the cases(81.48%) were asymptomatic, with a discreet predilection to the maxilla (57.41%). The compound type was more frequent than the complex, with 53.7% and 46.3% of the cases, respectively. The presentstudy was based in histological diagnosis, differently from other already published studies, which werebased in radiographic analysis. In spite of the differences between the studies in gender, age, extension,location and symptoms, several similarities were observed. New retrospective studies in differentpopulations are necessary in order to provide a better understanding of odontomas