鼻翼旁牙源性皮瘘13例报告

目的:总结鼻翼旁牙源性皮瘘的诊断与治疗的特点。方法:对13例鼻翼旁牙源性皮瘘的病例特点,进行回顾性分析。结果:13例患者拔除患牙,清刮瘘管,缝合切口后痊愈出院,随访无复发。结论:鼻翼旁牙源性皮瘘是因牙源性感染未得到有效控制,导致炎症穿破皮肤形成瘘道,长期不愈。拔除患牙去除感染根源,是此类病例确切有效的治疗方法。     

深覆[牙合]引发颏部皮瘘1例

颌面部牙源性皮瘘多见于青年人．慢性根尖周炎、智齿冠周炎是引起颌面部皮瘘的常见原因^[1]。在临床上常见到皮肤瘘道相对应的患牙出现深龋洞、残根、残冠或治疗史。经过对病灶牙根管治疗或拔除病灶牙后,病变均愈合。现将我科诊治的1例由深覆[牙合]引起下前牙咬合创伤。从而引发颏部皮瘘病例,报道如下.     

牙源性面部皮瘘恶变1例

牙源性面部皮瘘恶变１例广东省汕头市中心医院口腔科（邮５１５０３１）胡顺广牙源性面部皮疹恶变临床罕见报道。现将我科收治一例报告如下：患者，男，３５岁，患右侧鼻旁瘘经常肿痛２年余。在门诊以牙源性皮瘘拔除４冠残并搔刮瘘道，皮损随后愈合。三周后患处再次出现疹...     

深覆引发颏部皮瘘1例

颌面部牙源性皮瘘多见于青年人,慢性根尖周炎、智齿冠周炎是引起颌面部皮瘘的常见原因[1]。在临床上常见到皮肤瘘道相对应的患牙出现深龋洞、残根、残冠或治疗史。经过对病灶牙根管治疗或拔除病灶牙后,病变均愈合。     

颌面部皮瘘的误诊误治分析

颌面部的皮肤窦道（皮瘘）与相应部位的患牙有着密切关系,但由于患者不一定认识这点,以免贻误病情,给患者带来痛苦和损失。本文总结了１８例颌面部皮瘘误诊误治情况。１　临床资料１．１　一般资料　男性１０例,女性８例;年龄９～４５岁,其中３０岁以下１３例占７２．２％。前牙１０例,其中上颌４例,下颌６例,后牙８例,均在下颌。误诊时间最短３月,最长达８年。１．２　皮瘘临床情况　见表１。表１　皮瘘临床情况皮瘘部位牙位病因例数鼻前庭上中切牙慢性尖周炎２鼻翼旁上尖牙慢性尖周炎１内眦部上尖牙慢性尖周炎１颏部下切牙、尖…     

牙源性面部皮瘘54例临床报告

牙源性面部皮瘘是由于与牙齿有关的化脓性感染,脓液由皮肤开口排出,形成皮肤肉芽肿或瘘孔的疾病。临床上本病由于易忽略对病源牙的检查和处理,造成误诊误治,致使瘘管长期不愈。本文结合我科自1983年～1990年收治的54例牙源性面部皮瘘病例,探讨其临床表现特征、诊断及治疗等问题。     

颌面部牙源性皮瘘误诊13例分析

颌面部牙源性皮瘘是因牙源性感染未得到有效控制 ,导致炎症穿破皮肤形成瘘道 ,临床上该病被误诊的情况时有发生 ,本文总结了 13例颌面部牙源性皮瘘误诊病例 ,报告如下 :临床资料1.一般资料　本组 13例 ,男 8例 ,女 5例 ,年龄 9～ 40岁 ,平均 2 5岁。前牙 6例 ,其中上颌 4例 ,下颌 2例 ,后牙 7例 ,均在下颌。病程在 1周～ 5年之间 ,见附表。附表　 13例牙源性颌面部皮瘘临床资料 (ｎ =13 )皮瘘部位病源牙诊断病例数误诊眶下部上尖牙急性根尖周炎 1皮脂腺囊肿继发感染内眦部上尖牙急性根尖周炎 1泪囊炎鼻前庭上中切牙慢性根尖周炎 1鼻疖肿鼻翼…     

牙源性皮瘘的保守治疗

牙源性皮瘘临床报导较少。我科遇到8例牙源性皮瘘病例,男6例,女2例,年龄7～37岁。病期2月～3年,多在1年半左右。颏瘘2例,颊瘘4例,下颌缘瘘2例。病源牙为:下颌切牙2例,下颌双尖牙和磨牙6例。感染原因:龋源性尖周炎     

牙源性颌面部皮瘘的临床分析

面部皮瘘多为化脓性炎症 ,主要为牙源性感染引起。患者多来自农村 ,主要为误诊误治、延误治疗、患者不重视等原因导致瘘管长期不愈。本文总结本科 1 992年 1月至 1 996年 1 2月治疗的 34例 ,都为牙源性感染 ,现报告如下。1　临床资料1 .1　一般情况34例中 ,男性 2 0例 ,女性 1 4例 ;年龄 8～ 54岁 ,其中 1 8～ 2 5岁占 75% ;除 5例居住城市外 ,其余均来自农村。病程最短 2个月 ,最长 6个月。1 .2　临床表现皮瘘的部位、病因、病灶、牙位、病例数见附表。慢性根尖周炎占 64.7%。34例患者病灶牙均为死髓牙 ,临床表现无叩痛、牙体变色或不变色…     

牙源性皮瘘恶变1例

牙源性皮瘘恶变１例广东省汕头市中心医院口腔科胡顺广患者，男，３５岁。因右侧上牙疼痛伴面颊肿痛，于右鼻旁皮肤溃破溢脓，经服药治疗后，疼痛及肿胀消退，但皮肤破溃处仍间歇溢脓。迁延不愈２年。在门诊以牙源性皮瘘而拔除４残冠并搔刮瘘道，皮损随后愈合。３周后患处...     

Ectopic third molar in the mandibular condyle: A review of the literature

Objectives: To evaluate the etiopathogenesis, clinical features, therapeutic options, and surgical approaches for removal of ectopic third molars in the mandibular condyle. Study design: MEDLINE search of articles published on ectopic third molars in the mandibular condyle from 1980 to 2011. 14 well-documented clinical cases from the literature were evaluated together with a new clinical case provided by the authors, representing a sample of 15 patients. Results: We found a mean age at diagnosis of 48.6 years and a higher prevalence in women. In 14 patients, associated radiolucent lesions were diagnosed on radiographic studies and confirmed histopathologically as odontogenic cysts. Clinical symptoms were pain and swelling in the jaw or preauricular region, trismus, difficulty chewing, cutaneous fistula and temporomandibular joint dysfunction. Treatment included conservative management in one case and in the other cases, surgical removal by intra- or extraoral approaches, the latter being the most common approach carried out. In most reported cases, serious complications were not outlined. Conclusions: The etiopathogenic theory involving odontogenic cysts in the displacement of third molars to the mandibular condyle seems to be the most relevant. They must be removed if they cause symptoms or are associated with cystic pathology. The surgical route must be planned according to the location and position of the ectopic third molar, and the possible morbidity associated with surgery. Key words:Third molar, ectopic tooth, condyle, mandible.     

Case report of intra-osseous fibroma: a study on odontogenic and desmoplastic fibromas with a review of the literature

Intra-osseous fibromas of the jaw are classified by origin. Intra-osseous odontogenic fibromas have odontogenic epithelia, while desmoplastic fibromas do not. However, it is often difficult to determine the odontogenic origin for central fibromas. Three subjects with a diagnosis of intra-osseous fibroma were examined. Case 1 was a 35-year-old man found to have a panoramic radiograph from the right premolar to the mandibular ramus in the mandible that exhibited multilocular radiolucency. Within the radiolucency, small-radioopaque bodies were observed. Case 2 was a 13-year-old female, in whom a panoramic radiograph from the left premolar to the molar in the mandible showed multilocular radiolucency. Case 3 was a 51-year-old female who exhibited a heart-shaped radiolucency in the panoramic radiograph of the left first molar area in the mandible. We also reviewed the literature for previously reported cases of intra-osseous odontogenic and desmoplastic fibroma. In 64 cases of intra-osseous odontogenic fibroma and 68 cases of desmoplastic fibroma we extracted data on age, sex, location, and radiographic findings. Based on the analysis of the reported literature cases, re-evaluation of the patients in our study revealed that case 1 could be classified as desmoplastic fibroma, while cases 2 and 3 were intra-osseous odontogenic fibromas.     

Odontogenic carcinoma with sarcomatous proliferation. A case report

An unusual case of odontogenic carcinoma of the mandible showing a sarcomatous proliferation is described. The tumour had caused invasive bone destruction with extension into the soft tissues of the cheek. It was successfully treated by resection of the mandible and radical neck dissection. Although ameloblastomatous features were observed in an infrabony area, the majority of the intrabony lesion consisted of a proliferation of epithelial cells arranged in fine strands or networks which were randomly scattered in a collagenous stroma in the periphery. The tumour cells assumed a fibroblastic appearance and were intermingled with stroma cells in the extrabony lesion. The lesion could not be placed in any of the three entities of odontogenic carcinoma in the WHO classification.     

46例异位下颌第三磨牙及伴发病变的临床病例分析

［摘要］目的 探讨总结异位下颌第三磨牙及其伴发病变的临床、影像学特点和治疗方法。方法 收集自2012年1月—2017年12月就诊于南京医科大学附属口腔医院的下颌第三磨牙相关病例,经过全景片或CBCT诊断纳入异位下颌第三磨牙临床病例资料,分析其临床表现、影像学特点、伴发病变的病理表现以及治疗策略。 结果 共计46例（47颗）异位下颌第三磨牙符合纳入标准,主要好发于喙突、下颌支、下颌角及下颌骨体部。局部肿胀、疼痛及张口受限是其主要的临床症状,其中局部肿胀的发生与牙齿异位的解剖部位相关(P＜0.05)。89.37%异位下颌第三磨牙常伴有牙源性囊肿或肿瘤。多数病例采用口内入路行牙拔除术同期去除伴随病变,术后并发症较少。 结论 异位下颌第三磨牙较为少见,临床诊断主要依赖于影像学,常伴有牙源性囊肿或肿瘤性病变,手术治疗总体预后良好。     

Radiographic study of extension phase of chronic osteomyelitis of the mandible

It is thought that the phase of inflammatory extension in osteomyelitis of the mandible varies according to the primary site of infection, that is, the causative tooth. This study was conducted to analyze the relationship between the extension phase of inflammatory bone changes and the causative tooth in patients with radiographically diagnosised osteomyelitis of the mandible. Between 1983 and 1993, a total of 219 patients with osteomyelitis of the mandible were seen in our department. In the age distribution, 135 cases occurred in men and 98 cases in women. Osteomyelitis was most prevalent in patients in their sixties (39 cases) followed by patients in their forties and fifties (38 cases each). The causative tooth was identified in 97 cases of osteomyelitis in the mandible. In the 39 cases in which the primary infection was caused by the third mandibular molar, distal extension was most prevalent (30 cases). In the 58 cases in which a tooth other than the third mandibular molar was the cause (front tooth, premolar, deciduous tooth and other molars), equal extension in the mesio-distal direction was most prevalent (40 cases). In the upper-lower extension phase, lower extension beyond the mandibular canal was most prevalent in the first, second and third molar teeth. In the cases involving teeth other than the mandibular molars, the inflammatory bone changes were rather limited to the upper part of the mandibular canal.     

Radiographic features of a patient with both cemento-ossifying fibroma and keratocystic odontogenic tumor in the mandible: a case report and review of literature

We herein describe a rare case of a 48-year-old woman with both ossifying fibroma (OF) and keratocystic odontogenic tumor (KCOT) in the mandible. CT images showed a 15 × 15 × 20-mm radiolucent-radiopaque lesion with bucco-lingual bony expansion in the left first premolar equivalent area of the mandible, and a 15 × 40 × 35-mm well-defined unilocular radiolucent lesion in the left side of the mandible, extending from the distal side of the distal root of the left second molar to the left mandibular ramus. A biopsy of the radiolucent-radiopaque lesion and fenestration surgery of the radiolucent lesion were performed. Histopathologic examination revealed a fibro-osseous lesion (FOL) and a KCOT, respectively. CT was useful in diagnosing the radiolucent-radiopaque lesion as OF and for detecting the 3-dimensional bone expansion and the contents in the lumen of the KCOT.     

牙源性颈前部皮瘘误诊一例

目的探讨颌面部牙源性皮瘘的诊治方法。 方法回顾性分析1例牙源性颈前部皮瘘患者误诊的临床资料。 结果颈前部皮瘘由牙源性慢性感染所致,主要为相应部位的慢性根尖周炎引起,对病原牙拔除及瘘道切除,治疗后皮瘘痊愈,随访至今未见复发。 结论颌面部皮瘘需临床医生高度警惕牙源性感染,及时鉴别诊断和明确病因予以相关治疗,从而避免误诊误治。     

下颌骨几个变量与第三磨牙阻生的关系

目的:分析下颌骨几个变量与第三磨牙阻生的关系,以了解下颌第三磨牙阻生的发病机理.方法:曲面断层X线片83张,将146侧无缺牙、无多生牙且牙列无明显拥挤者测量下颌第三磨牙倾斜角(θ)、下颌角(a)、下颌骨嵴缘夹角(β)、磨牙后间隙长度(BX)、下颌骨牙槽长度(OB)和第三磨牙牙冠宽度(MD)并将结果进行分析.结果:磨牙后间隙长度、下颌骨牙槽长度和第三磨牙牙冠宽度与第三磨牙阻生相关,下颌角和嵴缘夹角角度与阻生牙无关.结论:下颌第三磨牙阻生与下颌骨发育相关,磨牙后间隙的长度、磨牙后间隙长度与第三磨牙牙冠宽度比值是主要的影响因素.     

Hybrid odontogenic ghost cell tumor and cutaneous pilomatrixoma: a highly unusual coexistence

This article describes the first published case of coexistence in a child of a rare hybrid odontogenic ghost cell tumor and a solitary cutaneous pilomatrixoma. An 11-year-old boy presented with a large well-defined unilocular radiolucent lesion in the right posterior mandible. Marsupialization followed by enucleation of the remaining lesion at a later period was the treatment of choice. Histopathologic analysis revealed a hybrid tumor demonstrating areas identical to calcifying cystic odontogenic tumor, ameloblastoma, ameloblastic fibro-odontoma, ameloblastic fibromyxoma, and adenoid odontogenic tumor. A cutaneous nodule was also removed from the facial area and demonstrated classic features of pilomatrixoma on histopathology. Sixteen cases of hybrid calcifying cystic odontogenic tumor associated with odontogenic tumors other than ameloblastomas and odontomas are referred in the literature to date. Young males are frequently affected, and the mandible is the most common site of involvement. The occurrence in the same patient of 2 distinctive entities, which both demonstrate ghost/shadow cells, may be a coincidental finding or suggest a common origin regarding the histogenesis of these cells. Alternatively, future molecular studies may clarify possible genetic or/and predisposing factors for the development of these lesions.     

Intramural calcifying epithelial odontogenic tumor

The calcifying epithelial odontogenic tumor (CEOT) is a rare lesion of the jaws. It accounts for about 1% of all odontogenic tumors. The CEOT occurs primarily in the molar-premolar region of the mandible, and 52% of cases are associated with an unerupted tooth. This report describes an unusual case in a 37-year-old woman. The tumor arose in the molar area of the right mandible, appeared radiographically as a radiolucent lesion, and was thought to be a dentigerous cyst in association with an impacted first molar. The lesion was enucleated. Microscopic examination showed it to be a dental sac, within which were the 3 elements of a typical CEOT: squamoid cells with eosinophilic cytoplasm, the homogeneous eosinophilic substance, and calcium salt deposits in the form of Liesegang rings.