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DELAYED ERUPTION OF LOWER FIRST MOLAR ASSOCIATED WITH AMELOBLASTIC FIBROMA

법랑모세포 섬유종에 의한 하악 제1대구치의 맹출지연

  • Jung, Jung-Hwa (Department of Pediatric Dentistry, School of Dentistry, Kyungpook National University) ;
  • Kim, Young-Jin (Department of Pediatric Dentistry, School of Dentistry, Kyungpook National University) ;
  • Kim, Hyun-Jung (Department of Pediatric Dentistry, School of Dentistry, Kyungpook National University) ;
  • Nam, Soon-Hyeun (Department of Pediatric Dentistry, School of Dentistry, Kyungpook National University)
  • 정정화 (경북대학교 치의학전문대학원 소아치과학교실) ;
  • 김영진 (경북대학교 치의학전문대학원 소아치과학교실) ;
  • 김현정 (경북대학교 치의학전문대학원 소아치과학교실) ;
  • 남순현 (경북대학교 치의학전문대학원 소아치과학교실)
  • Received : 2011.02.17
  • Accepted : 2011.06.25
  • Published : 2011.08.31

Abstract

Ameloblastic fibroma is rare true benign mixed odontogenic tumor. Most of these tumors occur in the posterior region of the mandible under 20 years of age. It develops generally associated with unerupted tooth and grows slowly on the surface of alveolar bone, therefore interferes normal tooth eruption. These lesions rarely showing a little bony expansion, are usually asymptomatic and are discovered incidentally on routine dental exam. It is similar to amleoblastic fibroodontoma and ameloblastic fibrodentinoma clinically and roentgenographically but represents no dental hard tissue formation histologically. Enucleation and curettage of surrounding bone are generally recommended options for treatment. Even though there are some reports of recurrence and malignant transformation and more aggressive treatment options like block resection are suggested sometimes, but in most cases, recurrence is unusual because it is well encapsulated and easily separated from adjucent bony socket. In these cases, we did conservative treatment such as enucleation and curettage to the patients who were visited for ameloblastic fibroma associated with delayed eruption of lower first molar. After regular check-ups, we found relatively natural eruption process of combined teeth.

법랑모세포 섬유종은 드문 진성의 혼합성 양성종양으로 20세 이하의 비교적 어린 연령층의 하악 후방부에 호발한다. 흔히 하악 구치부의 미맹출치와 관련하여 발생하며 치조골 표면에서 서서히 성장하여 이환치를 치근단 방향으로 변위시켜 정상적인 치아 맹출을 방해한다. 약간의 피질골 팽창 외에 다른 증상은 거의 없어서 정기적인 방사선학적 평가에서 우연히 발견되는 경우가 많다. 임상적 및 방사선학적으로 법랑모세포 섬유치아종 및 치아종과 비슷하나 조직학적으로 치아 경조직의 형성이 관찰되지 않는 것이 다르다. 치료방법은 적출술과 주위 골의 소파술을 포함한 보존적 외과적 처치가 일반적이나 재발가능성이 있고 악성종양으로의 변이를 보인다는 일부 보고가 있어 절제술과 같은 보다 공격적인 치료방법이 추천되기도 한다. 하지만 대부분의 병소는 피막으로 잘 둘러싸여 있으며 주변의 골와에서 쉽게 분리되므로 재발률은 낮은 편이다. 본 증례는 하악 좌측 제1대구치의 맹출지연과 관련된 법랑모세포 섬유종을 주소로 본과에 내원한 환아들을 대상으로 보존적인 적출술 및 소파술을 시행한 것으로 정기적인 관찰 결과 비교적 양호한 제1대구치의 자연적 맹출양상을 보여 보고하는 바이다.

Keywords

References

  1. Chen Y, Wang JM, Li TJ : Ameloblastic fibroma: a review of published studies with special reference to its nature and biological behavior. Oral Oncol, 43:960-969, 2007. https://doi.org/10.1016/j.oraloncology.2007.05.009
  2. Philipsen HP, Reichart PA, Praetorius F. Mixed odontogenic tumours and odontomas. Considerations on interrelationship. Review of the literature and presentation of 134 new cases of odontomas. Oral Oncol, 33:86-99, 1997. https://doi.org/10.1016/S0964-1955(96)00067-X
  3. Hansen LS, Ficarra G : Mixed odontogenic tumours: an analysis of 23 new cases. Head neck surg, 10:330-43, 1988.
  4. Pitak-Arnnop P, Chaine A, Dhanuthai K, et al. : Extensive ameloblastic fibroma in an adolescent patient: a case report with a follow-up of 4 years. Eur J Dent, 3:224-228, 2009.
  5. Barnes L, Evenson JW, Reichart P, et al. : The World Health Organization classification of tumours. Pathology and genetics of head and neck tumours. Lyon: IARC Press; 2005.
  6. Gibilisco JA : Stefne's oral radiographic diagnosis. WB Saunders, 5th edition, Philadelphia:191-195, 1985.
  7. Kruse A : Uber die Entwicklung cystischer Geschwu-lste im Unterkiefer. Arch Path Anat, 124:137-48, 1891. https://doi.org/10.1007/BF01984917
  8. Trodahl JN : Ameloblastic fibroma: survey of cases from the armed forces institute of pathology. Oral surg Oral med Oral pathol, 33:547-548, 1972. https://doi.org/10.1016/0030-4220(72)90367-2
  9. Baroni Ch, Farneti M, Stea S, et al. : Ameloblastic fibroma and impacted mandibular first molar, Oral surg Oral med Oral pathol, 73:548-549, 1992. https://doi.org/10.1016/0030-4220(92)90095-8
  10. 김승혜, 송제선, 손흥규 등 : 법랑모세포 섬유종에 의한 하악 제1대구치의 맹출 장애. 대한소아치과학회지, 37:102-108, 2010.
  11. Vasconcelos BC, Andrade ES, Rocha NS, et al. : Treatment of large ameloblastic fibroma : a case report. J Oral Sci. 51: 293-296, 2009. https://doi.org/10.2334/josnusd.51.293
  12. 대한구강악안면방사선학교수협의회, 구강악안면방사선학, 3판, 나래출판사, 372-374, 1991.
  13. Andreasen JO, Petersen JK, Laskin DM : Textbook and color atlas of tooth impactions. Mosby, 1st edition, 77-78, 199-203, 1997.
  14. Palma C, Coelho A, Gonza′lez Y, et al. : Failure of eruption of first and second permanent molars. J Clin Pediatr Dent. 27:239-246, 2003. https://doi.org/10.17796/jcpd.27.3.dm4v13441p161928
  15. Dimitrakopoulos I, Psomaderis K, Zaramboukas T : Ameloblastic fibroma of the mandible associated with root resorption and unerupted teeth: a case report. Quintessence Int, 39(6):523-527, 2008.
  16. Dallera P, Bertoni F, Marchetti C, et al. : Ameloblastic fibroma: a follow-up of six cases. Int J Oral Maxillofac Surg, 25(3):199-202, 1996. https://doi.org/10.1016/S0901-5027(96)80029-4
  17. Mohapatra PK, Choudhury AR, Parkash H : Ameloblastic fibroma in the midline of mandible: a case report. J Clin Pediatr Dent, 24:321-327, 2000. https://doi.org/10.17796/jcpd.24.4.a52j7477r4650366
  18. Takeda Y, Kaneko R, Suzuki A : Ameloblastic fibrosarcoma in the maxilla, malignant transformation of ameloblastic fibroma. Virchows Arch A Pathol Anat Histopathol, 404:253-263, 1984. https://doi.org/10.1007/BF00694891
  19. Kobayashi K, Murakami R, Fujii T, et al. : Malignant transformation of ameloblastic fibroma to ameloblastic fibrosarcoma: case report and review of the literature. J Craniomaxillofac Surg, 33:352-355, 2005. https://doi.org/10.1016/j.jcms.2005.04.006
  20. Grover PS, Lorton L : The incidence of unerupted permanent teeth and related clinical cases. Oral Surg Oral Med Oral Pathol, 59:420-425, 1985. https://doi.org/10.1016/0030-4220(85)90070-2
  21. 대한소아치과학회 : 소아.청소년 치과학, 4판, 신흥인터내셔날, 서울, 396, 2007.
  22. Alling CC, Catone GA : Management of impacted teeth. J Oral Maxillofac Surg, 51:3-6, 1993. https://doi.org/10.1016/0278-2391(93)90004-W
  23. 조윤정, 박영옥, 김태완 등 : 매복된 하악 제1대구치의 외과적 노출술을 이용한 치험례. 대한소아치과학회지, 34:322-327, 2007.
  24. Nielsen SH, Becktor KB, Kjaer I : Primary retention of first permanent mandibular molars in 29 subjects. European Journal of Orthodontics, 28:529-534, 2006. https://doi.org/10.1093/ejo/cjl049
  25. Takeda Y : Ameloblastic fibroma and related lesions: current pathologic concept, Oral Oncol, 35:535-540, 1999. https://doi.org/10.1016/S1368-8375(99)00039-1
  26. Muller S, Parker DC, Kapadia SB, et al. : Ameloblastic fibrosarcoma of the jaws. A clinicopathologic and DNA analysis of five cases and review of the literature with discussion of its relationship to ameloblastic fibroma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 79:469-477, 1995. https://doi.org/10.1016/S1079-2104(05)80130-1
  27. Zallen RD, Preskar MH, McClary SA : Ameloblastic fibroma, J Oral Maxillofac Surg, 40:513-517, 1982. https://doi.org/10.1016/0278-2391(82)90014-3