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Cementoblastoma mandibular: caso clínico
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O cementoblastoma é uma lesão benigna rara que representa menos de 1% a 6% de todos os tumores odontogénicos (Milani et al. 2012; Borges et al. 2019). Caracteriza-se pela proliferação de tecido tipo cimento e tende a estar associado a um dente permanente erupçionado, sendo o mais prevalente o primeiro molar. Neste trabalho é apresentado um caso clinico, pouco relatado na literatura face às suas dimensões, de um cementoblastoma que afetou o corpo mandibular esquerdo, estendendo-se do canino ao primeiro pré-molar, de uma mulher de 15 anos de idade. Foi realizada uma cirurgia sob anestesia geral, tendo sido excitada a exérese total da lesão e tendo a mesma sido enviada para análise histológica. A particularidade do seguinte caso foi a estrutura remanescente óssea extremamente fragilizada após a remoção da lesão, que apresentava um tamanho de 28×24 mm. Esta fragilidade levou a necessidade de utilização de placas de osteossíntese e bloqueio intermaxilar procurando evitar fratura iatrogénica da mandibula, conjuntamente a loca cirúrgica foi regenerada com um enxerto de crista ilíaca conjuntamente com osso autologo e sintético. A paciente foi monitorizada durante 9 meses após a cirurgia e não mostrou quaisquer sinais de recidiva.
Cementoblastoma is a rare benign lesion that represents less than 1% to 6% of all odontogenic tumours (Milani et al. 2012; Borges et al. 2019). It is characterised by proliferation of cementum-like tissue and in all cases tends to be associated with an erupting permanent tooth, most often the first molar. This paper presents a clinical case, little reported in the literature due to its dimensions, of a cementoblastoma that affected the left mandibular body, extending from the canine to the first premolar, of a 15-year-old woman. Surgery was performed under general anaesthesia, with total excision of the lesion being excited and sent for histological analysis. The particularity of the following case was the extremely fragile bone remnant structure after the removal of the lesion, which had a size of 28×24 mm. This fragility led to the need to use osteosynthesis plates and intermaxillary blockage, seeking to avoid iatrogenic fracture of the mandible, together with the surgical site being regenerated with an iliac crest graft together with autologous and synthetic bone. The patient was monitored for 9 months after surgery and showed no signs of recurrence.
Cementoblastoma is a rare benign lesion that represents less than 1% to 6% of all odontogenic tumours (Milani et al. 2012; Borges et al. 2019). It is characterised by proliferation of cementum-like tissue and in all cases tends to be associated with an erupting permanent tooth, most often the first molar. This paper presents a clinical case, little reported in the literature due to its dimensions, of a cementoblastoma that affected the left mandibular body, extending from the canine to the first premolar, of a 15-year-old woman. Surgery was performed under general anaesthesia, with total excision of the lesion being excited and sent for histological analysis. The particularity of the following case was the extremely fragile bone remnant structure after the removal of the lesion, which had a size of 28×24 mm. This fragility led to the need to use osteosynthesis plates and intermaxillary blockage, seeking to avoid iatrogenic fracture of the mandible, together with the surgical site being regenerated with an iliac crest graft together with autologous and synthetic bone. The patient was monitored for 9 months after surgery and showed no signs of recurrence.
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Keywords
Cementoblastoma mandibular Tumor odontogénico Osteossarcoma Osteíte esclerosante Displasia cemento-óssea florida Fios de sutura Corticosteroides em cirurgia oral Odontoma Fibroma ossificante Amoxicilina+ácido clavulanico cirurgia oral Hipercementose Mandibular cementoblastoma Odontogenic tumour Osteosarcoma Osteitis sclerosing Florid cemento-osseous dysplasia Suture threads Corticosteroids in oral surgery Odontoma Ossifying fibroma Amoxicillin+clavulanic acid in oral surgery Hypercementosis