牙瘤患者53例诊治分析

Diagnosis and treatment of odontomas:A retrospective study of 53 cases

目的:总结牙瘤临床、病理及诊疗的特点。方法:对53例牙瘤患者的年龄、性别、临床症状、影像学表现、治疗及预后进行回顾性分析。结果:53例牙瘤患者中,男女比例为1.12∶1。79.2%(42/53)的患者于18岁之前发现牙瘤。无临床症状的牙瘤占60.4%(32/53);其次为局部颌骨隆起,占30.2%(16/53);肿痛和胀感不适占9.4%(5/53)。牙瘤造成牙齿阻生的比例较高,达81.1%(43/53);7.5%(4/53)的病例出现邻近恒牙牙根吸收。81.1%(43/53)的牙瘤与正常骨组织之间存在清晰边界,边界不清者和部分边界不清者占18.9%(10/53)。组合性牙瘤为45例,占84.9%;混合性牙瘤8例,占15.1%。43例牙瘤根方存在埋伏牙,其中22例(22/43)因无法保留而被拔除;12(12/43)例自行萌出;9例(9/43)经正畸牵引达到理想位置。结论:牙瘤是一种成牙组织形成的牙源性肿瘤,通常影像学检查可获得确切诊断;牙瘤会造成牙齿移位、牙根吸收、牙齿阻萌等,手术法摘除效果较好,且不易复发。

Objective:To summarize the clinical,pathological,diagnosis and treatment characteristics of odontomas.Methods:The age,gender,clinical symptoms,imaging manifestations,treatment,and prognosis of 53 patients with odontomas were analyzed retrospectively.Results:Among the 53 patients with odontomas,the male∶female ratio was 1.12∶1.79.2%(42/53)of odontomas were found before the age of 18.Most odontomas patients were asymptomatic,accounting for 60.4%(32/53);followed by local jaw protrusion,accounting for 30.2%(16/53);swelling,pain and swelling discomfort,accounting for 9.4%(5/53).The proportion of impacted teeth caused by odontomas was high,reaching 81.1%(43/53);7.5%(4/53)of the cases had resorption of adjacent permanent teeth.81.1%(43/53)of the cases had a clear gap between the odontoma and normal bone tissue boundary,and 18.9%(10/53)of odontomas had ill-defined or partially ill-defined borders with normal tissue.There were 45 cases of compound odontoma,accounting for 84.9%,and 8 cases of complex odontoma,accounting for 15.1%.There were embedded teeth in the root of 43 cases,among which 22 cases extracted their teeth because they could not be retained;in 12 cases,the teeth erupted spontaneously;and 9 cases(9/43)achieved the ideal position by orthodontic traction.Conclusion:Odontoma is an odontogenic tumor formed by odontogenic tissue.Usually,an accurate diagnosis can be obtained with the help of imaging findings.Odontomas can cause tooth displacement,root resorption,tooth eruption resistance,etc.The effect of surgical removal is good and it is not easy to relapse.