J Korean Assoc Oral Maxillofac Surg.  2024 Jun;50(3):170-174. 10.5125/jkaoms.2024.50.3.170.

Conservative enucleation for physiologic space closure in adenomatoid odontogenic tumor

• Mustakim KR
• Eo MY
• Yoon HJ
• Kim SM

• KMID: 2557635
• DOI: http://doi.org/10.5125/jkaoms.2024.50.3.170

Abstract

Adenomatoid odontogenic tumor (AOT) is a rare, asymptomatic, slow-growing benign tumor that can be divided into three variants: follicular, extrafollicular, and peripheral. By treating AOT using an enucleation and curettage approach, recurrence can be avoided. We report a case of a 24-year-old female who presented with a lump in the right mandibular premolar area along with diastema between displaced teeth #43 and #44 and was diagnosed with extrafollicular AOT. The patient was managed with enucleation-curettage surgery without additional bone graft procedure along with routine follow-up. A successful outcome without recurrence was achieved, and diastema closure with repositioning of the displaced teeth did not require orthodontic treatment. AOT should be managed via enucleation and curettage to obtain successful outcomes without recurrence. Spontaneous bone regeneration following enucleation can be achieved without guided bone regeneration. Also, diastema closure and repositioning of displaced teeth can occur without orthodontic interventions through physiologic drift.

Keyword

Adenomatoid odontogenic tumor; Conservative treatment; Space closure; Tooth migration; Tooth movement

Figure

• 

  Fig. 1 A. Intraoral view demonstrated a round mass with diastema between displaced teeth #43 and #44 (arrows). B. Panoramic radiograph showed a semi-circular radiolucency with a coarse corticated margin in the upper part of the alveolar bone between teeth #43 and #44 roots (arrows). C. Axial computed tomography view showed a round, soft tissue attenuated lesion with a rough and thick corticated margin in the alveolar bone between the roots of teeth #43 and #44 (arrows).

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  Fig. 2 A. The retrieved 1.5-cm-diameter circumscribed round mass. Representative histopathological features of adenomatoid odontogenic tumor. B. The tumor is surrounded by a thick fibrous capsule and contains small amounts of calcification (asterisks). H&E staining; scale bar=40 μm. C. Sheets of spindle-shaped tumor cells showing whorled areas or duct-like and tubular structures. H&E staining; scale bar=100 μm.

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  Fig. 3 A. Two months following surgery, the soft tissue was in the healing process and the space between teeth #43 and #44 was reduced (arrows). B. Lateral intraoral view showed tooth #43 repositioning and diastema closure without orthodontic interference (arrows). C. Panoramic view nine months following surgery revealed full bone healing with no recurrence of the adenomatoid odontogenic tumor and proximal contact of teeth #43 and #44 (arrows).

Reference

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