Ameloblastoma da mandíbula: relato de dois casos

OBJETIVO: Este estudo teve como objetivo avaliar os principais aspectos radiográficos e epidemiológicos das lesões de células gigantes (granulomas centrais de células gigantes e tumores marrons do hiperparatireoidismo). MATERIAIS E MÉTODOS: A amostra consistiu de 26 lesões de células gigantes diagnosticadas em 22 pacientes divididos em dois grupos, um deles composto por 17 pacientes que não tinham hiperparatireoidismo (grupo A) e o outro formado por cinco pacientes portadores de tal distúrbio (grupo B). RESULTADOS: O sexo feminino (72,7%) foi o mais acometido. As lesões ocorreram mais freqüentemente na segunda década de vida, com média de idade de 27 anos. A mandíbula (61,5%) foi o arco mais envolvido. Radiograficamente, 57,7% das lesões eram multiloculares e 42,3% eram uniloculares com limites definidos. Todas as 26 lesões provocaram expansão óssea, 15,4% produziram reabsorção radicular, 50% causaram deslocamento dentário e 11,5% produziram dor. Na mandíbula, 18,7% das lesões cruzavam a linha média. O grupo A apresentou 66,7% das lesões na mandíbula e o grupo B mostrou igualdade na distribuição das lesões entre os arcos. O grupo A apresentou 66,7% das lesões multiloculares e 33,3%, uniloculares. O grupo B apresentou 62,5% das lesões uniloculares e 37,5%, multiloculares. CONCLUSÃO: As lesões de células gigantes podem manifestar-se, radiograficamente, com um amplo espectro, desde pequenas lesões uniloculares de crescimento lento até extensas lesões multiloculares. Elas apresentam características de benignidade, embora algumas lesões possam demonstrar um comportamento localmente agressivo.

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“…Radiographically, ameloblastoma may manifest itself as a well-defined unilocular radiotransparency with or without the presence of sclerotic margins, frequently associated with an unerupted tooth, or as multilocular radiotransparency, that may be described in terms of the phrases "honeycombs" or "soap bubbles". Ameloblastomas can be extensive, to the point of perforating the bony cortex, invading the soft tissue, or resorbing and/ or displacing teeth [1,13,16]. In the present clinical case, the radiograph revealed a multilocular appearance, with root resorption of teeth 36 and 37 and displacement of tooth 38, with no report of any paresthesia in the region, which can occur in advanced cases of ameloblastoma [17].…”

Section: Discussionmentioning

confidence: 48%

“…Ameloblastoma is regarded as the variant with the highest rate of recurrence, more aggressive [10] and more common than the unicystic or extraosseous form [11,12]. The final diagnosis is performed via a microscopic examination, however clinical examinations, and imaging examinations using radiography and computed tomography, help to provide a differential diagnosis [13].…”

Section: Clinical Casementioning

confidence: 99%

Extensive ameloblastoma in young patient: 5-year follow-up with no recurrence using conservative treatment

Silva

Santos²,

Carli

et al. 2018

RGO, Rev. Gaúch. Odontol.

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Ameloblastoma is a benign, odontogenic tumor that, due to its low rate of incidence, slow growth and local invasiveness, can be treated with a variety of surgical approaches, ranging from conservative to radical procedures. The conventional variant of ameloblastoma, though, is more aggressive and common, presenting a higher rate of recurrence than the unicystic and extraosseous/peripheral types; usually, the treatment of choice for this variant employs more invasive procedures. This report is of a 13-year-old male patient who presented with a swelling on the posterior mandibular region, on the left side of his face. Intraoral examination revealed lingual displacement of teeth 36 and 37. The clinical, radiographic and histopathological analyses confirmed the diagnosis of ameloblastoma (plexiform histological type). The patient was treated with curettage and peripheral osteotomy and a 5-year follow-up examination showed the area to have healed completely, with no evidence of recurrence. Consequently, although the clinical management of ameloblastoma is often based on invasive surgical approaches, large tumors treated with conservative surgery are less aesthetically and functionally impaired, and may demonstrate good prognosis with no recurrence in the 5-year follow-up period, as in the case reported here.

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“…Odontogenic tumors are neoplasms derived from the cells responsible for odontogenesis. 1 According to the tissue origin, they are classified as epithelial, mesodermal or mixed. Ameloblastomas are the commonest tumors of epithelial origin and account for around 23% of odontogenic tumors.…”

Section: Introductionmentioning

confidence: 99%

Ameloblastoma: a clinical and therapeutic analysis on six cases

Moraes

Cardoso

Rodrigues

et al. 2014

Revista Brasileira de Ortopedia (English Edition)

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Ameloblastomas are odontogenic tumors that are locally invasive and slow-growing. Their etiology is still not well defined, but the forms of treatment have been widely discussed because of the possibility of tumor recurrence and postoperative complications. In this study, six patients who were diagnosed with ameloblastoma in the mandibular region and were treated in the Department of Orthopedics and Traumatology of Hospital das Clínicas, Federal University of Goiás, between 1958 and 1963, were evaluated. The radiological, clinical and therapeutic characteristics were evaluated. There was no predominance regarding gender in the sample studied. The symptoms most often presented by the patients were pain and tumor formation. The radiological characteristics with greatest incidence were multilocular lesions and the treatment used for all the patients was radical surgery. There was no recurrence over the minimum follow-up period of one year and six months.

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“…O diagnóstico do ameloblastoma, considerando os fatos acima, não é tão simples, já que pouco pode revelar a inspeção e palpação clínica. Contudo a história e a evolução da lesão é muito importante, e além da avaliação imagenológica, o recurso de maior valia para o diagnóstico, ainda é a biópsia (Araújo;Araújo, 1984;Rosa et al, 1999;Sá et al, 2004).…”

Section: Características Clínicas E Epidemiológicasunclassified

Ameloblastomas: evolução clínica-histopatológica de 85 casos com ênfase em aspectos de metaplasia escamosa e queratinização e sua correlação com o epitélio odontogênico do germe dental

Dias¹

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Ameloblastoma da mandíbula: relato de dois casos

Cited by 9 publications

References 5 publications

Aspectos radiológicos e epidemiológicos do granuloma central de células gigantes

Extensive ameloblastoma in young patient: 5-year follow-up with no recurrence using conservative treatment

Ameloblastoma: a clinical and therapeutic analysis on six cases

Ameloblastomas: evolução clínica-histopatológica de 85 casos com ênfase em aspectos de metaplasia escamosa e queratinização e sua correlação com o epitélio odontogênico do germe dental

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