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• W1996693054 abstract "To the editor: A 5-year-old girl was referred for treatment because of a long-standing swelling in the mental region. Examination revealed a slight asymmetry of the chin and a hard, painless swelling under the buccal mental mucosa (Fig 1). Radiographic examination revealed a 3×2 cm, well circumscribed radiopaque image, containing several tooth-like structures, leading to a diagnostic hypothesis of a cistic compound odontoma (Fig 2, Fig 3). The tumor was slightly situated to the left side of the sagittal plane. In the postero-anterior (PA) image, it is possible to distinguish the central and lateral right lower incisors, apparently not involved by the radiopaque mass (Fig 2). The patient was admitted to the hospital and enucleation of the lesion was performed under general anesthesia. After a conventional buccal incision, the lesion was readily accessed after removing the thiny cortical bone plate. An encapsulated single piece tumoral mass was enucleated, leaving an empty bone cavity. The dental follicles corresponding to the four lower incisors were not visible after careful examinations of the remaining cavity. The specimen was dissected by cleavage in order to find and separate the dental follicles from the rest of the hard, malformed tumoral mass (Fig 4).Fig 2Postero-anterior radiographic image of the mental region.View Large Image Figure ViewerDownload (PPT)Fig 3Lateral radiographic image of the mental region.View Large Image Figure ViewerDownload (PPT)Fig 4Surgical specimen showing the four dental follicles separated from the rest of the tumor.View Large Image Figure ViewerDownload (PPT) The four dental follicles were found due to its peculiar size, form, and different color from the odontoma mass. It was decided for a tentative replantation. The parents of the patient were consulted by the surgical team, and, after explanation of the unexpected situation, an informed consent was obtained for the replantation procedure. The dental follicles were carefully positioned in the bottom of the cavity, near the lingual plate, with no efforts to identify the side or vestibulo-lingual position of the teeth. The cavity was filled with blood, and the mucosa was sutured with 3-O Vicril. Histologic examination confirmed the diagnosis of compound odontoma. A 1-year post-operative panoramic radiograph showed the four lower incisors in a relatively good position for eruption. The deciduous incisors were still in place, and there were signs of bone filling of the surgical cavity (Fig 5). By the fourth year post-operatively, the incisors have erupted in a surprisingly good manner, but in rotated positions (the buccal surfaces facing lingually) (Fig 6).Fig 64 years post-operative panoramic radiograph.View Large Image Figure ViewerDownload (PPT) After eight-year follow-up, a general dentist made a crown-plasty of the four incisors, with esthetic and functional modifications. The final result of the patient by this time is shown in Fig 7. This case presents some peculiarities that should be considered. Considering the fairly good results obtained in this unusual case, we were encouraged to present it, in spite of its peculiarities." @default.
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• W1996693054 date "2004-04-01" @default.
• W1996693054 modified "2023-10-16" @default.
• W1996693054 title "Dental follicles replantation after enucleation of an odontoma" @default.
• W1996693054 doi "https://doi.org/10.1016/j.tripleo.2003.12.038" @default.
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