This is a 12-year-old male patient whose mother goes to the dental office for aesthetic and functional nonconformity due to the clinical absence of the dental organ 21, the professional based on radiographic studies, diagnosed the presence of a compound odontoma.
At the time of consultation the patient is asymptomatic, there is slight enlargement of the vestibular cortical bone and clinical absence of dental organ 21.
Radiographic examination revealed multiple radiopaque areas of density similar to dental tissues located in the premaxilla, causing retention of the dental organ 21 and well circumscribed radiulucid zone adjacent to the lesion.
The dental organ is located with a 45 degree inclination in mesial direction to the tumor area.
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As a family history the mother reports that the father suffers from hypertension, as a personal history the mother does not comment relevant data for the clinical case.
When evaluating the clinical and radiographic condition, it was decided to perform a single surgical procedure in which excision of the lesion was proposed, including placing a tensile button ortodron to achieve eruption of the dental organ.
For this purpose, the patient is orthodontic, where treatment is initiated aimed at expanding the maxilla in the left upper arch area achieving the required space.
Six months after starting orthodontic treatment, the necessary space is obtained and the compound odontoma is excised under local anesthesia (2% lidocaine), using bilateral infraorbital technique.
The mucoperitic curettage was made to send buccal intrasurcular dental lesion from organ 12 to dental organ 23, lifting a flap of complete thickness Newman type; proceeding to the location and enucleation of the odontoma, taking the complete care of bone.
Associated with this, osteotomy is performed around the included tooth and resin cementation of an orthodontic traction button to help in the eruption of the included dental organ.
The surgical field was cleaned with saline solution and the flap was replaced with simple sutures with 3-0 silk.
All postoperative recommendations are given and antibiotics and analgesics are formulated.
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In the histopathological study, abundant fibrous and hypercellular connective tissue surrounding islots and bands of epithelial tissue composed of control cells layers of bone x-ray absorptive segmental fibroma was found. The typical diagnosis was panblastic fibrotic scarring.
Radiographic control is indicated within 6 months and then annual control for the first 5 years.
