RESUMO
RESUMEN Con relativa frecuencia, en la mucosa bucal se observan agrandamientos gingivales como el fibroma osificante periférico, que es una lesión reactiva inflamatoria del tejido blando. Clínicamente se trata de una tumefacción deformante, de crecimiento lento, sin una causa clara, aunque su formación está asociada a traumatismos o irritaciones crónicas a nivel gingival. Usualmente su aparición es a nivel de la papila interdental en la zona anterior del maxilar, aunque se puede observar en otras regiones de la cavidad bucal. El tratamiento es quirúrgico y consiste en la enucleación total de la lesión, retirando además los factores irritativos. En las radiografías, la imagen frecuentemente observada, aparece como un área radiolúcida, unilocular, bien definida y delimitada por un halo radiopaco (esclerótico); ocasionalmente puede presentarse como una imagen radiopaca.
ABSTRACT In the buccal mucosa are observed, with relative frequency, gingival enlargements such as the peripheral ossifying fibroma, which is considered a reactive inflammatory soft tissue lesion. It is clinically characterized by a slow-growing, disfiguring swelling with no clear cause, although its formation is associated with trauma or chronic irritation at the gingival level. Its appearance is usually at the level of the interdental papilla in the anterior region of the maxilla, although it can be seen in other regions of the oral cavity. The treatment is surgical consisting of the total enucleation of the lesion and removing the irritating factors. On radiographs, the frequently observed image appears as a well-defined, unilocular, radiolucent area delimited by a radiopaque halo (sclerotic); it can be occasionally presented as a radiopaque image.
Assuntos
Neoplasias Ósseas , Fibroma Ossificante/cirurgiaRESUMO
Los tumores de cavidades paranasales presentan una baja frecuencia. Dentro de éstos, entre los benignos destacan las lesiones fibroóseas que se caracterizan por el reemplazo de hueso normal por estroma celular fibroso. Dentro de estas lesiones se describen osteoma, displasia fibrosa y fibroma osificante. Se revisan 3 casos de pacientes del Hospital Clínico de la Universidad de Chile y se presenta una revisión bibliográfica en cuanto a las lesiones fibroóseas, su clínica, diagnóstico, imagenología y tratamiento.
The tumors of paranasal cavities present a low frequency. Among the benign tumors are fibro-osseous lesions characterized by the replacement of normal bone by fibrous cell stroma. Osteoma, fibrous dysplasia, and ossifying fibroma are described within these lesions. Three cases of patients from the Hospital Clínico de la Universidad de Chile are reviewed and a bibliographic review is presented regarding the fibro-osseous lesions, their clinical features, diagnosis, imaging and treatment.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Osteoma/cirurgia , Osteoma/diagnóstico por imagem , Neoplasias dos Seios Paranasais/cirurgia , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Fibroma Ossificante/cirurgia , Fibroma Ossificante/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Fibroma Ossificante , EndoscopiaRESUMO
RESUMEN: El fibroma osificante periférico (FOP) es una hipertrofia benigna de los tejidos. Se localiza en la región de la papila interdental, proveniente de células que derivan del ligamento periodontal. Generalmente mide menos de 1,5cm de diámetro, siendo muy raro en recién nacidos. El objetivo de la presentación de este caso clínico es describir un caso de FOP en un bebé de 6 meses de edad. La niña presentaba una lesión nodular localizada en la mucosa gingival, en el área de incisivos inferiores, de aproximadamente 1,5cm diámetro, de consistencia firme, lisa, y coloración igual a la de la mucosa subyacente. Un diente neonatal había sido removido a los 2 meses de nacida. El FOP es una lesión poco común y que raramente puede encontrarse en bebés menores de un año de edad; por este motivo es importante realizar el diagnóstico adecuado, para evitar cualquier complicación debido a su establecimiento precoz y rápido crecimiento.
ABSTRACT: The peripheral ossifying fibroma (POF) is a rare, reactive and inflammatory gingival overgrowth, arising on the interdental papilla, from cells derived of the periodontal ligament. Usually its diameter is less than 1.5 cm. It's uncommon in newborns, frequently occurring in teenagers and young adult. The purpose of this report is to describe a case of FOP in a six months old baby. She had a nodular lesion, located on the gingival mucosa of the lower incisor area, of approximately 1.5 cm; it was firm, smooth, pedunculated, with an equal color of the underlying mucosa. A neonatal tooth had been removed four months back. Although FOP is a rare injury, it can be found in infants with less than one year of age, which is why it is important to make the right diagnosis, and an opportune treatment, to avoid further complications due to its early establishment and rapid growth.
Assuntos
Humanos , Feminino , Lactente , Neoplasias Ósseas/diagnóstico , Fibroma Ossificante/diagnóstico , Neoplasias Ósseas/cirurgia , Fibroma Ossificante/cirurgia , Diagnóstico DiferencialRESUMO
Objetivo: Introducir la tecnología de impresión tridimensional para la creación de modelos anatómicos para asistir la planificación quirúrgica de tumores mandibulares. Caso clínico: Presentamos el caso de una paciente de 30 años con historial de tumoración en la mandíbula, sector anterior, con 2 años de evolución. La biopsia incisional confirmó que se trataba de un fibroma osificante. Con la asistencia de la tecnología de impresión tridimensional se realizó la planificación quirúrgica para establecer los márgenes de osteotomías y el predoblado de la placa de reconstrucción. Adicionalmente se describe en detalle el proceso de construcción del modelo de prototipado rápido con la tecnología de impresión tridimensional.
Aim: Introduction of three-dimensional printing technology for the generation of medical rapid prototyping models, an assistant tool in surgical planning of mandibular tumors. Clinical case: We report the case of a 30-years-old female patient who presented an anterior mandible mass with 2 years of evolution. Incisional biopsy confirmed ossifying fibroma. With the assistance of three-dimensional printing technology, 3D model was created and surgical planning was performed with the design of osteotomy sites for mandibular resection. Furthermore, prebending of reconstruction plate based on 3D model was accomplished. The protocol for rapid prototyping models creation in details is described in this article.
Assuntos
Humanos , Feminino , Adulto , Neoplasias Mandibulares/cirurgia , Fibroma Ossificante/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Impressão Tridimensional , Cuidados Pré-Operatórios , Transplante Ósseo , Cirurgia Assistida por Computador , Modelos AnatômicosRESUMO
The purpose of the present article was to present a clinical case of an 11-year-old girl with peripheral ossifying fibroma (POF). Additionally, after performing a literature review, we identified clinical information that occurs more frequently in association with POF, such evidence would help professionals in yielding a specific diagnosis and tailor a more specific therapeutic approach with the objective to decrease morbidities' associated with POF. This lesion represents the third most common lesion of all localized reactive hyperplastic lesions. Clinical aspects related to this pathology include the fact that it occurs most frequently in women between the first and second decades of life. It affects anterior maxillary region and interferes with normal functioning of this anatomical structure. After conducting the literature search, we found that it can also be presented in a considerable number of males with pain and hyperemia being the most common clinical manifestations. We found that often clinical cases are presented with incomplete information. It is important that in order to get to a consensus with respect to updates about information related to this lesion, new case series that include complete clinical information, radiographic analysis, and histopathology tests could be presented.
Assuntos
Neoplasias Ósseas/diagnóstico , Fibroma Ossificante/diagnóstico , Neoplasias Maxilares/diagnóstico , Biópsia , Neoplasias Ósseas/patologia , Neoplasias Ósseas/cirurgia , Criança , Diagnóstico Diferencial , Feminino , Fibroma Ossificante/patologia , Fibroma Ossificante/cirurgia , Humanos , Masculino , Maxila/patologia , Maxila/cirurgia , Neoplasias Maxilares/patologia , Neoplasias Maxilares/cirurgia , Radiografia Panorâmica , Tomografia Computadorizada por Raios XRESUMO
El fibroma osificante es un tumor benigno casi idéntico al fibroma cementificante. Se inscribe dentro de las llamadas lesiones fibroóseas, como la displasia fibrosa y la displasia cemento-osificante, que se caracterizan por el reemplazo de la arquitectura ósea normal por fibroblastos, tejido fibroso y cantidades variables de tejido mineralizado. Debido a sus características clínicas, radiológicas e histológicas, la clasificación de estas lesiones ha sido muy controversial. Presentamos un caso clínico en mandíbula, detalladno su diagnóstico y tratamiento y una revisión de la literatura...
Assuntos
Humanos , Adulto , Feminino , Doenças Maxilomandibulares/classificação , Fibroma Ossificante/cirurgia , Fibroma Ossificante/diagnóstico , Fibroma Ossificante/patologia , Argentina , Biópsia , Unidade Hospitalar de Odontologia , Fibroma Ossificante , Prognóstico , Procedimentos Cirúrgicos Bucais/métodos , Tomografia Computadorizada por Raios X/métodosRESUMO
Peripheral ossifying fibroma (POF) is a relatively uncommon gingival growth that is considered to be reactive in nature and appear secondary to irritation or trauma. It presents as an exophytic growth with smooth surface. POF in older age group, observance of calcification in radiograph of excised specimen, pathologic migration, mobility and size greater than 2 cm is an occasional entity. The article presents such a rare case of POF in a 60-year-old female patient which was treated by surgical excision. This case contradicts the logic that this lesion occurs in teenagers and in second and third decades of life
El fibroma osificante periférico (FOP) es un crecimiento gingival poco común, considerado reactivo por su naturaleza y en general se manifiesta secundario a una irritación o trauma y se presenta como un crecimiento exofítico de superficie lisa. En grupos de mayor edad, el FOP muestra calcificación radiográfica, migración patológica, movilidad y un tamaño mayor de 2 cm, es de carácter ocasional. Se presenta un caso raro de FOP en una paciente de 60 años que fue tratado mediante excisión quirúrgica. Este caso, contradice su lógica de aparición en adolescentes o adultos entre la segunda y tercera década de la vida
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Neoplasias Ósseas/cirurgia , Neoplasias Ósseas/diagnóstico , Neoplasias Gengivais/cirurgia , Neoplasias Gengivais/diagnóstico , Fibroma Ossificante/cirurgia , Fibroma Ossificante/diagnóstico , CalcinoseRESUMO
The aim of this study was to assess the clinical, radiographic and microscopic features of a case series of ossifying fibroma (OF) of the jaws. For the study, all cases with OF diagnosis from the files of the Oral Pathology Laboratory, University of Ribeirão Preto, Ribeirão Preto, SP, Brazil, were reviewed. Clinical data were obtained from the patient files and the radiographic features were evaluated in each case. All cases were reviewed microscopically to confirm the diagnosis. Eight cases were identified, 5 in females and 3 in males. The mean age of the patients was 33.7 years and most lesions (7 cases) occurred in the mandible. Radiographically, all lesions appeared as unilocular images and most of them (5 cases) were of mixed type. The mean size of the tumor was 3.1 cm and 3 cases caused displacement of the involved teeth. Microscopically, all cases showed several bone-like mineralized areas, immersed in the cellular connective tissue. From the 8 cases, 5 underwent surgical excision and 1 patient refused treatment. In the remaining 2 cases, this information was not available. In conclusion, OF occurs more commonly in women in the fourth decade of life, frequently as a mixed radiographic image in the mandible. Coherent differential diagnoses are important to guide the most adequate clinical approach. A correlation between clinical, imaginological and histopathological features is the key to establish the correct diagnosis.
O objetivo deste estudo foi analisar as características clínico-radiográficas e microscópicas de uma série de casos de fibroma ossificante (FO). Para o estudo, todos os casos com diagnóstico de FO do arquivo do Laboratório de Patologia Bucal da Universidade de Ribeirão Preto, Ribeirão Preto, São Paulo, Brasil, foram estudados. Os dados clínicos foram coletados das fichas de encaminhamento das lesões ao Laboratório. As características radiográficas foram avaliadas em cada caso. Todos os casos foram revisados microscopicamente para confirmação do diagnóstico. Oito casos foram identificados, 5 em mulheres e 3 em homens. A idade média dos pacientes foi de 33,7 anos e a maioria das lesões (7 casos) ocorreu na mandíbula. Radiograficamente todas as lesões se apresentavam como imagens uniloculares e a maioria (5 casos) se mostravam como imagem mista. O tamanho médio do tumor foi de 3,1 cm e 3 casos causavam deslocamento dos dentes envolvidos. Microscopicamente, todos os casos apresentavam várias áreas mineralizadas semelhantes a osso, imersas em um tecido conjuntivo celularizado. Dos 8 casos, 5 foram submetidos a excisão cirúrgica da lesão e 1 paciente recusou tratamento. Nos outros 2 casos, essa informação não estava disponível. Conclui-se que o FOs ocorrem mais comumente na mandíbula de pacientes do gênero feminino durante a quarta década de vida e se apresentam frequentemente como uma imagem radiográfica mista. Diagnósticos diferenciais coerentes são importantes para guiar a conduta clínica mais adequada. A correlação entre as características clínicas, imaginológicas e histopatológicas é a chave para estabelecer o diagnóstico correto.
Assuntos
Adulto , Feminino , Humanos , Masculino , Fibroma Ossificante/patologia , Neoplasias Maxilomandibulares/patologia , Brasil , Diagnóstico Diferencial , Fibroma Ossificante , Fibroma Ossificante/cirurgia , Neoplasias Maxilomandibulares , Neoplasias Maxilomandibulares/cirurgiaRESUMO
This clinical report describes the multidisciplinary treatment of a 16-year-old girl diagnosed with cemento-ossifying fibroma in the mandible. The resection of the lesion and reconstruction with a free osseous fibula flap with microvascular anastomosis was performed. Four months later, interpositional bone grafting of iliac spongy bone was used to gain bone height at the treated site. Twenty-four months later, 5 dental implants were placed. After a 6-month osseointegration period, a partial screw-retained fixed dental prosthesis was fabricated. Prosthodontic planning and treatment considerations are discussed.
Assuntos
Enxerto de Osso Alveolar , Implantação Dentária Endóssea , Prótese Dentária Fixada por Implante , Prótese Parcial Fixa , Fibroma Ossificante/reabilitação , Mandíbula/cirurgia , Neoplasias Mandibulares/reabilitação , Adolescente , Placas Ósseas , Feminino , Fibroma Ossificante/cirurgia , Humanos , Neoplasias Mandibulares/cirurgia , Retalhos CirúrgicosRESUMO
Central ossifying fibroma (COF) is a benign osteogenic neoplasm, with fibrous tissue and calcifications similar to bone, which has the clinical presentation of an asymptomatic bulging. It is more common in the mandibular premolar and molar region, in the third and fourth decades of life, and in women more frequently than men. Surgical removal is the treatment of choice and additional reconstruction is essential due to the functional and esthetic problems faced by the patient. This article describes the surgical treatment and subsequent reconstruction in a 22-year-old man with COF and an expansile lesion of the anterior maxilla. Enucleation of the lesion was performed and porous high-density polyethylene biomaterial was used for reconstruction.