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Clinical Pathological Conference---Compound Odontoma

General Data:Name: ? X X Chart No.: 2935590-6Ward No.: B108

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Clinical Pathological Conference---Compound Odontoma

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    1. Clinical Pathological Conference---Compound Odontoma Wu Cheng-Hsien, Division of Oral & Maxillofacial Surgery, Department of Dentistry, V.G.H.-Taipei

    2. General Data: Name: ? X X Chart No.: 2935590-6 Ward No.: B10816 Sex: Male Birthday: 74/02/08 Marital status: Single Date of admission: 89/06/19 Occupation: Student

    3. Chief Complaint: Refer from LDC for removal of radiopaque lesion over Rt lower mandibular region. History of Present Illness: According to the statement of this 15 y/o boy, a few days ago , he went to LDC for regular dental check-up and scaling. The Dr. take the apical film & found this odontoma and suggested him to visit VGH OS OPD for help. So he admitted our ward B108-16 for surgery intervention for odontoma removal under GA.

    4. Past Medical/Dental History: General: DM(-) , HTN(-) , Heart disease (-) Allergies: food and drug(-) Trauma: significant injuries (-), blood transfusion (-) Social and Personal History: Tobacco: Nil Alcohol: Nil Betel quid chewing: Nil Family History: Family lipoma history , and now there is a lipoma over his right arm. Review of Systems: No specific finding

    5. OMS condition: Extraoral: No facial asymmetry No LAP Intraoral: retained deciduous tooth: 83 Pano. Finding: >Impaction:18,28,38,48 >A well-defined radiopaque-radiolucent lesion with radiolucent encapsulation about 1.5x1.5cm over 42-45 apical area >33: ectopic eruption

    13. Odontoma General features: Mixed odontogenic tumor; epithelial and mesenchymal origin A kind of harmatoma Etiology: Result from an extraneous bud of odontogenic epithelial cells from the dental lamina Epidemiology: The most common odontogenic tumor(67%); Compound> Complex(2:1)> ameloblastic odontoma> ameloblastic fibroodontoma

    14. Age: Occur in the 2nd decade of life (most common in childen and young adults) Sex: M~F (68% of the complex type occur in women) Site: Compound---incisor-canine area of the maxilla; Complex-- 1st and 2nd molar of the mandible Size: 1-3cm Progress: Non-aggressive Symptoms: Delayed eruption of permanent tooth

    15. Ameloblastic odontoma (AO; odontoameloblastoma) Simultaneous occurence of an ameloblastoma and complex odontoma Clinical similarities to both the odontoma (age at time of diagnosis) and ameloblastoma (location, expansion and recurrent rate) aggressive; rare; benign More often in children early in the 2nd decade of life; ?>?; mandible>maxilla Bony expansion; cortex destruction; teeth displacement; mild pain

    16. Ameloblastic Fibroodontoma Contain cords & nests of odontogenic epithelium & some calcified odontogenic tissue in a myxomatous stroma benign, well-capsulated ?>?; most often in the first two decades of life mandible>maxilla; most in the premolar-molar area pericoronal to an imbedded tooth radiolucent-->radiolucent-radiopaque D.D.: COC; AOT; CEOT; odontoma Management: surgical enucleated

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