Odontoma: a clinicopathologic study of 81 cases.
Odontoma: a clinicopathologic study of 81 cases.
复制标题
牙瘤：81 例临床病理研究。
DOI：
10.29828/jfma.200312.0009
复制
发表时间：
2003
期刊：
影响因子：
--
通讯作者：
C. Chiang
中科院分区：
文献类型：
--
作者：
Julia Yu;Jeng;Yi;Bu;A. Sun;C. Chiang
背景和目的
牙瘤是最常见的牙源性肿瘤。包括复合型和复合型两种类型。台湾地区尚未有一系列有关牙瘤临床及组织学特征的研究。这项研究评估台湾人牙瘤的临床病理特征。
方法
纳入了1998-2002年间从病历中发现的牙瘤病例。对患者的显微特征、X线表现和临床病史进行了回顾和分析。
结果
共81例患者的81颗牙瘤(男36例，女45例)纳入研究。复合型牙瘤62例，复合型牙瘤19例。患者的平均年龄为18岁，大多数牙瘤发生在生命的第一个十年(32%)和第二个十年(38%)。牙瘤明显好发于上颌(70%)和颌骨前部(83%)，尤其是上颌前部(62%)。81颗牙中有64颗(79%)有80颗阻生牙，其中恒牙71颗，乳牙2颗，多生牙7颗。在71颗阻生恒牙中，最常见的是上颌中切牙(27%)，其次是上颌尖牙(26%)和下颌尖牙(24%)。组织学检查显示牙釉质基质占90%，牙本质占100%，牙骨质占88%，牙髓组织占96%，纤维包膜占93%，鬼细胞占83%，釉质上皮减少占86%，牙源性上皮巢占58%。9%的牙瘤与含牙囊肿有关。
结论
在这个系列中，牙瘤最常发生在出生后的第一个和第二个十年。虽然复杂的牙瘤多见于后颌骨，但在这组台湾人的病例中，最常见的是上颌前牙。牙瘤通常与阻生的牙齿有关，偶尔还会伴有含牙的囊肿。术后随访1~15年，未发现牙瘤复发。
BACKGROUND AND PURPOSE
Odontoma is the most common odontogenic tumor. It includes 2 types, the compound and complex odontomas. There has not been a series study of the clinical and histologic features of odontomas from Taiwan. This study evaluated the clinicopathologic features of odontoma in Taiwanese.
METHODS
Cases of odontoma treated from 1998 to 2002 identified from medical records were included. The microscopic features, radiographic features, and clinical history of the patients were reviewed and analyzed.
RESULTS
A total of 81 odontomas in 81 patients (36 males and 45 females) were included. There were 62 compound and 19 complex odontomas. The mean age of the patients was 18 years with the majority of odontomas occurring in the first (32%) and second decade (38%) of life. Odontomas had a marked predilection for the maxilla (70%) and for the anterior region of the jaw (83%), particularly for the anterior maxilla (62%). Sixty four (79%) of the 81 odontomas were associated with 80 impacted teeth, including 71 permanent teeth, 2 deciduous teeth, and 7 supernumerary teeth. Of the 71 impacted permanent teeth, the maxillary central incisor (27%) was most commonly affected, followed by the maxillary canine (26%) and mandibular canine (24%). Histologic examination revealed enamel matrix in 90%, dentin in 100%, cementum in 88%, pulp tissue in 96%, fibrous capsule in 93%, ghost cells in 83%, reduced enamel epithelium in 86%, and nests of odontogenic epithelium in 58% of odontomas. Dentigerous cyst was associated with 9% of odontomas.
CONCLUSIONS
In this series, odontomas occurred most often in the first and second decade of life. Although complex odontomas are usually found in the posterior jaw, in this Taiwanese series they were most commonly found in the anterior maxilla. Odontoma is frequently associated with an impacted tooth and occasionally with a dentigerous cyst. No recurrence of odontomas was found after surgical excision with follow-up of 1 to 15 years.