Two-stage surgical removal of large complex odontoma
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The surgical treatment of a large complex odontoma in the mandibular angle is reported. Four possible surgical approaches to remove a benign tumor in the mandibular angle are discussed.
A two-stage surgical treatment was chosen; first, removing most part of the lesion and preserving the second molar, decreasing the risk of a pathological mandibular fracture. A maxillo-mandibular fixation for a period of 4 weeks was used. The patient was oriented to maintain a soft diet. The second surgical stage occurred 3 months after the first one due to the significant bone consolidation observed, reducing the possibility of a mandibular fracture. The remaining lesion and the second molar were then completely removed.
This case demonstrates the value of the tridimensional computed tomography in treatment planning prior to any definitive surgery. A computed tomography should be made in every case of intraosseous lesion in order to establish the intraosseous extent of the tumor, cortical perforation, and soft tissue involvement for precise guidance for the surgical planning. It is recommended that the surgeon considers excision by an intraoral, lingual approach when indicated, and in two stages, when an extremely thin mandibular base is present.
KeywordsOdontogenic tumors Complex odontoma Computed tomography
- 3.Patiño Illa C, Berini Aytés L, Sánchez Garcés MA, Gay Escoda C (1995) Odontomas complejos y compuestos: Análisis de 47 casos. Arch Odontoestomatol 11:423–429Google Scholar
- 15.Mild Y, Iwaya N, Hirota M, Yamada N, Aisaki K, Sato J, Ishii T, Iwanari G, Mikyake M, Kudo I, Komiya K (1999) Clinicopathological studies of odontoma in 47 patients. J Oral Sci 41:173–176Google Scholar
- 18.Bodin I, Julin P, Thomsson M (1984) Odontomas and their pathological sequels. Dentomaxillofac Radiol 12:109–114Google Scholar
- 20.Neville BW, Damm DD, Allen CM, Bouquet JE (2002) Bone pathology. In: Neville BW, Damm DD, Allen CM, Bouquet JE (eds) Oral and Maxillofacial Pathology, 3rd edn. Saunders, Philadelphia, pp 660–664Google Scholar
- 26.Kuramochi MM, Vanti LA, Berenguel IA, Pereira WL, Zangrando D (2006) Acesso Extra-Oral para Reconstrução Primária em Odontoma Complexo raro em mandíbula. Rev Port Estomatol Cir Maxilofac 47:35–40Google Scholar