Presentation of a keratocystic odontogenic tumor with agenesis: a case report

Abstract

IntroductionWe analyzed the etiopathogenetic, clinical, radiographic, and histopathologic aspects of keratocystic odontogenic tumors, particularly in association with dental anomalies of number, with the aim of providing useful information for their correct diagnosis, treatment, and prognosis within a multidisciplinary approach.Case presentationA 14-year-old Caucasian girl presented for observation of bilateral agenesis of the upper incisors, which was diagnosed by orthopantomography. Approximately one year after starting orthodontic treatment, the patient went to the emergency department because of a phlegmonous tumefaction of the lateroposterior upper left maxillary region. Diagnostic orthopantomography and axial computed tomography scan results of the facial skeleton revealed a large lesion occupying the left maxillary sinus, rhizolysis of dental elements 26 and 27, and dislocation of dental element 28. The lesion and infected sinus mucosa were removed through surgical antral-cystectomy with the Caldwell-Luc approach. Histological examination of the lesion confirmed the suspected diagnosis of keratocystic odontogenic tumor. The 12-month follow-up orthopantomography and computed tomography scan results showed good trabecular bone formation in the lesion area. The 24-month follow-up results showed optimal healing in the area of the lesion, positive pulp vitality tests for teeth 26 and 27, and good periodontal tissue healing, as verified through periodontal probing.ConclusionsCombined with our observations from a careful review of the literature, the results of the case study suggest that keratocystic odontogenic tumor and dental agenesis probably do not develop through a common genetic cause. More likely, they are caused by related environmental factors. Management of this case required the multidisciplinary collaboration of different specializations and careful planning to devise a correct therapeutic protocol and reach a favorable prognosis.

Interdisciplinary surgical and orthodontic treatment of odontogenic keratocyst of the mandibular body in a 12-year-old female patient, with a relapse after 7 years of observation: a case report

“…Orthodontic treatment of patients with extensive odontogenic cysts is a great therapeutic challenge, exemplary and close cooperation with the surgeon and the patient is required. In the domestic and foreign literature, only a few works can be found presenting a complete description of surgical and orthodontic treatment of patients due to keratocysts [12,16]. In presented case, the lack of orthodontic intervention could be associated with loss of teeth 43, 44 and 45, and the need for subsequent prosthetic treatment.…”

Abordagem clínica e terapêutica sobre o Tumor Odontogênico Ceratocístico: uma revisão abrangente da literatura

“…21 casos -Dor 10,11,14,33,34,36,42,43,49,51,53,59,60,68,69,78,79,82,83 ; b. 4 casos -Mobilidade dentária 13,18,85,86 ; c. 3 casos -Retenção dentária 15,61,62 , parestesia 19,33,37 , formação de úlceras 33,86 , obstrução nasal 55,60,73 ; d. 2 casos -Presença de fístula 49,88 , supuração 66,82 ; e. 1 caso -Proptose ocular 73 , limitação de abertura bucal 44 , lesão ulcerada de bordos endurecidos 43 , sangramento 33 , exodontia prévia 14 ; 3. 7 casos -Somente dor 14,22,32,74,76,91 , não reportado 54,84,89,…”

“…53 casos -Não reportado [10][11][12][14][15][16]18,25,27,30,33,35,36,41,46,50,51,55,56,[58][59][60][61]63,64,[66][67][68][71][72][73]75,76,79,81,[82][83][84][87][88][89]91 ; 2. 20 casos -CO 8,9,13,17,19,22,28,29,31,37,39,…”

“…O aspecto imaginológico, em geral, caracterizou-se por ser uma área radiolúcida única [8][9][10][12][13][14]15,[17][18][19]43,44,[46][47][48][49][50][51][52][53][54][55][56]58,60,62,64,[66][67][68]70,[73][74][75][76][78][79][80][81][82][83][84][85][86][87][88][89][90][91] ou múltipla 11,14,42,…”

“…1. 42 casos -Somente enucleação 9,10,13,15,16,18,20,23,94,26,29,30,[44][45][46][47][48]50,52,53,57,59,60,62,65,[69][70][71]76,81,84,92 ; 2. Enucleação associada a: a.…”