ABSTRACT The odontogenic keratocyst represents 3 to 11% of all odontogenic cysts. It occurs from childhood to old age with a higher incidence in men. The mandible is involved in 60% to 80% of cases, with a frequency in the body and ramus. Smaller lesions are usually asymptomatic and diagnosed by radiographic examination. However, larger lesions may be associated with pain and increased volume. Radiographically, radiolucent unilocular or multilocular lesions with sharp, corticalized edges are observed, associated with an impacted tooth. A clinical case of a 30-year-old male patient, who exhibits an atypical expression, is presented. A double lesion of odontogenic keratocysts independent of each other appears, located in the right mandibular ramus and body, treated in the Maxillofacial Surgery Service of the San José Hospital, Santiago de Chile. Diagnosis and surgical treatment performed are described. The clinical interest of the case is the presence of two lesions independent of each other, with the same diagnosis. It seems fundamental to us to report it in the scientific literature due to its high scope and impact.

RESUMEN: El queratoquiste odontogénico constituye del 3 a 11% de los quistes odontogénicos. Se presenta desde la infancia hasta la vejez con mayor incidencia en hombres. La mandíbula está involucrada en el 60% al 80% de los casos, con una frecuencia en cuerpo y rama. Las lesiones de menor tamaño suelen ser asintomáticos, diagnosticados por examen radiográfico, no obstante, las lesiones más grandes pueden estar asociadas con dolor y aumento de volumen. Radiográficamente se observan lesiones uniloculares o multiloculares radiolúcidas de bordes nítidos, corticalizados, asociado a un diente retenido. Se presenta caso clínico de paciente género masculino de 30 años de edad, que exhibe una expresión atípica. Manifestándose como una doble lesión de queratoquistes odontogénicos independientes entre sí, localizados en rama y cuerpo mandibular derecha, tratado en el Servicio de Cirugía Maxilofacial del Hospital San José, Santiago de Chile. Se describe diagnóstico y tratamiento quirúrgico realizado. El interés clínico del caso es la presencia de dos lesiones independientes entre sí, con el mismo diagnóstico. Presentación que nos parece fundamental reportar en la literatura científica debido a su alto alcance e impacto.

Resumen Objetivo Presentar un caso clínico de un tumor odontogénico epitelial calcificante (TOEC), así como una revisión de la literatura disponible sobre esta neoplasia para contribuir al análisis del mejor método de tratamiento de la patología. Caso clínico Se presenta el caso de una paciente mujer de 35 años con un tumor odontogénico epitelial calcificante que recibió tratamiento de enucleación quirúrgica con una evolución favorable y seguimiento de 5 años por medio de evaluación clínica y radiológica. La elección terapéutica se basó en el resultado de un análisis exhaustivo de la literatura para determinar el mejor abordaje de la neoplasia.

Abstract Aim To present a clinical case of a calcifying epithelial odontogenic tumor (CEOT), as well as a review of the available literature on this neoplasia to contribute to the analysis of the best treatment method for the pathology. Clinical case The case of a 35-year-old patient with a calcifying epithelial odontogenic tumor who received surgical enucleation treatment with a favorable evolution and 5-year follow-up through clinical and radiological evaluation is presented. The therapeutic choice was based on the result of an exhaustive analysis of the literature to determine the best approach to the neoplasia.

Resumo O cancro afeta significativamente a população mundial, tendo sido estimado, em 2018, que o Cancro da Cabeça e Pescoço seria o sétimo mais prevalente. As células claras podem ser resultado de diferentes processos fisiológicos e são encontradas em diversos tumores benignos e malignos. Embora sejam raras nos tumores da cabeça e pescoço, são encontradas maioritariamente nas glândulas salivares. Os tumores de células claras da cabeça e pescoço, nomeadamente o Carcinoma Hialinizante de Células Claras e o Carcinoma Odontogénico de Células Claras são tumores malignos, morfologicamente e geneticamente semelhantes, com impacto funcional, psicológico, social e estético nestes doentes. Os exames histopatológicos e imuno-histoquímicos são fundamentais para distinguir as lesões de células claras de outros diagnósticos diferenciais. Este trabalho tem como objetivo demonstrar a variabilidade clínica de apresentação associada à sobreposição imuno-histoquímica destes dois tipos de tumores de células claras da cabeça e pescoço.

Abstract Cancer significantly affects the world's population, and it was estimated in 2018 that Head and Neck Cancer would be the seventh most prevalent. Clear cells can be the result of different physiological processes and are found in various benign and malignant tumours. Although they are rare in head and neck tumours, they are mostly found in salivary glands. Clear cell tumours of the head and neck, namely Hyalinizing Clear Cell Carcinoma and Odontogenic Clear Cell Carcinoma are malignant tumours, morphologically and genetically similar, with functional, psychological, social and aesthetic impact on these patients. Histopathological and immunohistochemical tests are essential to distinguish clear cells lesions from other differential diagnoses. This work aims to demonstrate the clinical variability of presentation associated with the immunohistochemical overlap of these two types of clear cell tumours of the head and neck.

RESUMEN: El fibroma ameloblástico (FA) es una neoplasia benigna con potencial de recurrencia y transformación maligna que afecta los huesos maxilofaciales. Se analizaron casos recientes de FA para describir sus características clínicas y opciones de tratamiento. El objetivo de este estudio es mejorar la comprensión de esta enfermedad poco común y brindar información relevante para el diagnóstico y manejo de los pacientes. Se realizó una revisión de la literatura en busca de reportes de caso de FA publicados en los últimos 5 años. Después de eliminar duplicados, se seleccionaron 16 estudios para su análisis. Se recopilaron datos sociodemográficos, ubicación de la lesión, signos clínicos, hallazgos radiográficos y opciones de tratamiento. Los estudios incluidos en el análisis reportaron casos de FA en pacientes con edades entre 4 y 21 años. Se observó una ligera predominancia en hombres. La ubicación más común de la lesión fue la mandíbula posterior. Los signos clínicos más frecuentes fueron el aumento de volumen óseo y el dolor. Radiográficamente, se encontraron principalmente lesiones radiolúcidas multiloculares. El tratamiento más común fue la enucleación de la lesión. No se observaron recurrencias durante el seguimiento de los casos reportados. Los resultados coinciden con la literatura reciente, proporcionando información actualizada sobre el perfil clínico y radiográfico del FA. La enucleación se muestra como una opción efectiva de tratamiento. Estos hallazgos contribuyen al diagnóstico preciso y al manejo adecuado de los pacientes con FA, resaltando la importancia de comprender las características clínicas de esta neoplasia.

ABSTRACT: Ameloblastic fibroma (AF) is a benign neoplasm with the potential for recurrence and malignant transformation that affects the maxillofacial bones. Recent cases of AF were analyzed to describe their clinical characteristics and treatment options. The objective of this study is to enhance understanding of this rare disease and provide relevant information for the diagnosis and management of patients. A literature review was conducted to identify case reports of AF published in the past 5 years. After removing duplicates, 16 studies were selected for analysis. Sociodemographic data, lesion location, clinical signs, radiographic findings, and treatment options were collected. The included studies reported cases of AF in patients aged between 4 and 21 years. There was a slight male predominance. The most common location of the lesion was the posterior mandible. The most frequent clinical signs were increased bone volume and pain. Radiographically, predominantly multilocular radiolucent lesions were found. The most common treatment was lesion enucleation. No recurrences were observed during the follow-up of the reported cases. The results align with recent literature, providing updated information on the clinical and radiographic profile of AF. Enucleation emerges as an effective treatment option. These findings contribute to accurate diagnosis and appropriate management of patients with AF, highlighting the importance of understanding the clinical characteristics of this neoplasm.

RESUMEN: El fibro-odontoma ameloblástico (FOA) es una neoplasia odontogénica benigna poco frecuente que afecta a los huesos maxilares. Posee un componente de tejido epitelial y ectomesénquima, por lo que hasta hace un tiempo era incluido dentro de la clasificación de tumores odontogénicos de origen mixto. Actualmente estas lesiones no están incorporadas en la última clasificación de los tumores odontogénicos y huesos maxilofaciales de la organización mundial de la salud y son consideradas como un odontoma en desarrollo. Clínicamente se presenta con mayor frecuencia en mandíbula y asociado a la falta de erupción de un diente. Presentamos el caso clínico de un niño de 6 años de edad que acudió a nuestro servicio maxilofacial por la no erupción de un diente temporal mandibular. El cuadro clínico y las investigaciones confirmaron la hipótesis diagnóstica de FOA con una impactación del segundo molar temporal inferior izquierdo hacia el margen basilar mandibular y el germen dentario del premolar por sobre la corona del diente retenido.

ABSTRACT: Ameloblastic fibro-odontoma (AFO) is a rare benign odontogenic neoplasm that affects the maxillary bones. It possesses both an epithelial and ectomesenchymal component, for which it was previously included in the classification of mixed odontogenic tumors. The AFO is currently not included in the latest classification of odontogenic and maxillofacial bone tumors, and is considered a developing odontoma. Clinically, it predominantly manifests in the mandible, in frequent association with the lack of eruption of a tooth. In this article, the authors present a case of a 6 year old boy with the query of an unerupted primary mandibular tooth. Both the clinical examination and the subsequent investigation confirmed the diagnostic hypothesis of an AFO with subsequent impaction of the primary left mandibular second molar, which was displaced against the base of the mandible, and the tooth germ for the left mandibular second premolar positionedover the crown of the retained tooth.

ABSTRACT The orthokeratinized odontogenic cyst is an odontogenic cyst of uncommon development. The jaws are the most common site of involvement. Cysts of the jaw with keratinization, the odontogenic keratocyst (OKC), and the orthokeratinized odontogenic cyst (OOC) have attracted the most attention. The case of a 34-year-old female patient is presented, with a 2-month history of progressively growing swelling in the region of the left maxillary sinus accompanied by mucopurulent rhinorrhea and purulent discharge from an oroantral fistula. Surgery is performed under general anesthesia, a cystic lesion with keratin content is verified in the maxillary sinus whose histopathology returns compatible with orthokeratinized odontogenic cyst.

RESUMEN El quiste odontogénico ortoqueratinizado es un quiste odontogénico de desarrollo poco común. Los maxilares son el sitio más común de afectación. Los quistes mandibulares con queratinización, el queratoquiste odontogénico (OKC) y el quiste odontogénico ortoqueratinizado (OOC) son los que han atraído una mayor atención. Se presenta el caso de una paciente de sexo femenino de 34 años de edad, con historia de 2 meses de evolución de tumefacción de crecimiento progresivo en región de seno maxilar izquierdo acompañado de rinorrea mucopurulenta y salida se secreción purulenta por fístula oroantral. Se realiza cirugía bajo anestesia general, se constata una lesión quística de contenido queratínico en seno maxilar cuya histopatología retorna compatible con Quiste odontogénico ortoqueratinizado.

RESUMEN Introducción: El fibromixoma odontogénico es un tumor benigno poco frecuente de origen mesenquimal. Las lesiones menores pueden ser asintomáticas y se descubren sólo durante un examen radiográfico de rutina, y las lesiones mayores se asocian a expansión indolora del hueso involucrado, con desplazamiento de dientes y perforación ósea. La opción de tratamiento es quirúrgica existiendo desde el tratamiento conservador hasta la escisión radical. Reporte de caso: Presentamos dos casos de fibromixoma en mandíbula en una mujer de 17 años y varón de 18 años. El diagnóstico fue anatomopatológico. En ambos se realizó el tratamiento conservador de enucleación con osteotomía periférica y extracción de las piezas dentarias involucradas, con evolución favorable. Discusión: El tratamiento conservador con abordaje intrabucal es una alternativa humanística que mantiene su valor de éxito, evolución favorable y gran aceptación por los pacientes.

ABSTRACT Introduction: Odontogenic fibromyxoma is a rare benign tumor of mesenchymal origin. Small tumors may be asymptomatic and are discovered only during the routine radiographic examination, and large tumors are associated with the painless expansion of bone with the displacement of teeth and bone perforation. The treatment option is surgical and can range from conservative treatment to radical excision. Case Report: We report two cases of fibromyxoma in the mandible in a 17-year-old woman and an 18-year-old man. The diagnosis was anatomopathological. Both underwent conservative enucleation treatment with peripheral osteotomy and extraction of the affected teeth with favorable evolution. Discussion: Conservative treatment with an intraoral approach is a humanistic alternative that maintains its value of success, favorable evolution, and great acceptance by patients.

Abstract Tooth development depends on a series of reciprocal signaling interactions between the oral epithelium and ectomesenchyme. This study aimed to investigate the role of CK14, a protein involved in Wnt-1/β-catenin signaling, in odontogenesis and the development of odontomas. This cross-sectional, retrospective, immunohistochemical study analyzed 30 compound odontomas, 30 complex odontomas, and 17 tooth germs. Higher immunoexpression of CK14 was observed in odontogenic epithelial cells of tooth germs (p < 0.001) and odontogenic epithelial cells of odontomas (p < 0.001). There was higher immunoexpression of Wnt-1 and β-catenin proteins in epithelial cells of tooth germs (p = 0.002 and p < 0.001, respectively), as well as in the ectomesenchyme of odontomas (p = 0.003 and p < 0.001, respectively). β-Catenin was moderately and significantly correlated with CK14 in the membrane of reduced enamel epithelial cells in odontomas (p = 0.007). Higher immunoexpression of CK14 was observed in the odontogenic epithelium during the bud and cap stages and lower immunoexpression in the internal enamel epithelium during the bell stage. In odontomas, lower expression of Wnt-1/β-catenin and higher immunoexpression of CK14 were found in odontogenic epithelial cells, especially adjacent to the mineralized material resembling the tooth formed in these lesions.

Resumo O desenvolvimento dentário depende de uma série de interações de sinalização recíproca entre o epitélio oral e o ectomesênquima. O objetivo deste estudo foi investigar o papel da CK14 das vias WNT-1/β-catenina na odontogênese e no desenvolvimento de odontomas. Este estudo transversal, retrospectivo, imuno-histoquímico analisou 30 odontomas compostos, 30 odontomas complexos e 17 germes dentários. A CK14 apresentou maior imunoexpressão em células epiteliais odontogênicas de germes dentários (p<0,001) e em células epiteliais odontogênicas de odontomas (p<0,001). A Wnt-1 e a β-catenina apresentaram maior imunoexpressão de proteínas nas células epiteliais dos germes dentários (p = 0,002 e p<0,001, respectivamente), bem como no ectomesênquima dos odontomas (p = 0,003 e p < 0,001, respectivamente). A β-catenina correlacionou-se moderada e significativamente com a CK14 na membrana de células epiteliais reduzidas do esmalte em odontomas (p = 0,007). Maior imunoexpressão da CK14 foi observada no epitélio odontogênico nos estágios de botão e capuz com menor imunoexpressão no epitélio interno do órgão do esmalte no estágio de sino. Nos odontomas, foi observado menor expressão de Wnt-1/β-catenina e maior imunoexpressão da CK14 presente nas células epiteliais odontogênicas, especialmente, vizinhas ao material mineralizado semelhante ao dente formado nessas lesões.

Abstract Cementoblastoma is a rare and benign odontogenic mesenchymal tumor, usually characterized by the formation of cementum-like tissue produced by neoplastic cementoblasts attached around the roots of a tooth. The tumor has unlimited growth potential. Often the suggested treatment is tumor resection together with the associated tooth. We present a clinical case of large proportions of cementoblastoma located in the posterior region of the mandible in a young male patient.

Resumo O cementoblastoma é um tumor mesenquimatoso odontogénico raro e benigno, geralmente caracterizado pela formação de tecido semelhante ao cemento produzido por cementoblastos neoplásicos ligados em redor das raízes de um dente. O tumor tem potencial de crescimento ilimitado. Frequentemente o tratamento sugerido é a ressecção tumoral em conjunto com o dente associado. Apresentamos um caso clínico de cementoblastoma de grandes proporções localizado na região posterior de mandíbula num paciente jovem do género masculino.

Resumo O presente estudo analisou a expressão de proteínas envolvidas na via de sinalização Sonic Hedgehog (SHH, SMO e GLI-1) em lesões benignas do epitélio odontogênico de comportamento biológico distintos, tais como ceratocistos odontogênicos (CO), ameloblastomas (AMB) e tumores odontogênicos adenomatoides (TOA), com o intuito de identificar o papel destas proteínas na patogênese destas lesões. A amostra foi constituída de 20 CO, 20 AMB e 10 TOA, analisada pela técnica da imuno-histoquímica de forma semiquantitativa por compartimento celular, onde foi feita uma análise da membrana e citoplasma das células nas proteínas SHH e SMO, enquanto que para a proteína GLI-1, foi feita uma análise nuclear e/ou citoplasmática. Para análise estatística, foram utilizados os testes de Kruskal-Wallis (KW), Mann-Whitney (U) e Spearman (r), com o nível de significância estabelecido em 5% (p < 0,05). Ao analisar a proteína SHH, observou-se que o AMB demonstrou expressão membranar/citoplasmática significativamente maior em comparação ao TOA (p = 0,022) e CO (p = 0,020). Com relação à análise membranar/citoplasmática da SMO, não foram identificadas diferenças entre as lesões estudadas. Para a proteína GLI-1, foram constatadas diferenças estatisticamente significativas, em nível nuclear, para o AMB e CO em comparação ao TOA (p< 0,0001). Além disso, foram observadas correlações positivas com significância estatística entre GLI-1 citoplasmático e GLI-1 nuclear para o AMB (r = 0,482; p = 0,031) e CO (r = 0,865; p< 0,0001), e entre o SMO membranar/citoplasmático e o GLI-1 citoplasmático para o TOA (r = 0,667; p = 0,035) e o CO (r = 0,535; p = 0,015). Os resultados deste estudo confirmam a participação da via de sinalização Sonic Hedgehog na patogênese das lesões estudadas e, a superexpressão de SHH em AMBs e GLI-1 nuclear em AMBs e COs, indica que estas proteínas contribuem com o comportamento biológico mais agressivo destas duas lesões quando comparado ao TOA.

Abstract The present study analyzed the expression of proteins involved in the sonic hedgehog signaling pathway (SHH, SMO, and GLI-1) in benign epithelial odontogenic lesions (odontogenic keratocyst - OKC, ameloblastoma - AB, and adenomatoid odontogenic tumor - AOT) in order to identify the role of these proteins in the pathogenesis of these lesions. The sample consisted of 20 OKCs, 20 ABs, and 10 AOTs. The Kruskal-Wallis, Mann-Whitney U, and Spearman’s (r) tests were used for statistical analysis, with the level of significance set at 5% (p < 0.05). The membrane/cytoplasmic expression of SHH was significantly higher in AB compared to AOT (p = 0.022) and OKC (p = 0.02). No differences were found in the membrane/cytoplasmic expression of SMO between the lesions studied. Regarding GLI-1, significant differences were observed at the nuclear level for AB and OKC compared to AOT (p < 0.0001). In addition, significant positive correlations were found between cytoplasmic and nuclear GLI-1 in AB (r = 0.482; p = 0.031) and OKC (r = 0.865; p < 0.0001), and between membrane/cytoplasmic SMO and cytoplasmic GLI-1 in AOT (r = 0.667; p = 0.035) and OKC (r = 0.535; p = 0.015). The results of this study confirm the participation of the sonic hedgehog signaling pathway in the pathogenesis of the lesions studied. Overexpression of SHH in ABs and nuclear expression of GLI-1 in ABs and OKCs indicate that these proteins contribute to the more aggressive behavior of these two lesions when compared to AOT.

RESUMEN Introducción: El fibroma ameloblástico es un tumor odontogénico mixto benigno y poco frecuente que generalmente se presenta como un abombamiento indoloro en pacientes jóvenes. En este artículo realizamos una revisión de la literatura y presentamos nuestra experiencia en el manejo del ameloblastoma fibroblástico en 4 casos. Material y métodos: Realizamos una revisión de los casos publicados en la literatura en PubMed entre 2015 y 2022. En cuanto a nuestra experiencia, se realizó una búsqueda en el departamento de Anatomía Patológica de los casos de fibroma ameloblástico confirmados histológicamente. Resultados: La búsqueda arrojó 29 resultados, de los cuales solo 9 fueron seleccionados. Todos los artículos fueron reportes de casos únicos, y la mayoría de ellos se localizaron en la mandíbula (77,7 %). La mayoría de los pacientes se sometieron a enucleación y curetaje, y ninguno de los autores informó de recurrencia. Encontramos 4 casos operados en nuestro departamento en los últimos 15 años. Dos lesiones se localizaron en el maxilar y dos en la mandíbula. En todos los casos se realizó enucleación y curetaje, incluyendo exodoncia de los dientes afectados, con evolución muy favorable y sin recidivas. Discusión: El manejo puede ser conservador, realizándose enucleación y curetaje con una evolución muy favorable. Se han descrito tasas variables de recurrencia y se ha identificado una variante maligna, por lo que se debe realizar un seguimiento a largo plazo. En la literatura encontramos solo informes de casos únicos, la mayoría de los casos se presentaron en la mandíbula y se sometieron a un tratamiento conservador con resultados favorables. En nuestra serie no observamos recidivas, con buena regeneración ósea y recibiendo tratamiento de ortodoncia posterior.

ABSTRACT Introduction: Ameloblastic fibroma is a rare benign mixed odontogenic tumor that usually presents as a painless swelling in young patients. In this article we performed a literature review and present our experience in the management of fibroblastic ameloblastoma in 4 cases. Material and methods: We performed a review of cases published in the literature in PubMed between 2015 and 2022. Regarding our experience, research in the Anatomical Pathology department was done to find cases of ameloblastic fibroma that had been histologically confirmed. Results: The search rendered 29 results, of which only 9 were selected. All articles were single case reports, and most of them were located in the mandible (77,7 %). Most patients underwent enucleation and curettage, and no recurrence were reported by any of the authors. We found 4 cases operated in our department in the last 15 years. Two lesions were located in the maxilla and 2 in the mandible. In all cases, enucleation and curettage was performed, including extraction of the teeth involved, with a very favorable evolution and no recurrences. Discussion: Management can be conservative, performing enucleation and curettage with a very favorable evolution. Variable rates of recurrence have been described and a malignant variant has been identified, so long-term follow-up must be done. In the literature we found only single case reports, with most of the cases presenting in the mandible and undergoing conservative treatment with favorable results. In our series we did not observe recurrences, with good bone regeneration and receiving subsequent orthodontic treatment.

RESUMEN El mixoma odontogénico mandibular es un tumor mesenquimal de comportamiento benigno, recurrente y localmente invasivo, su principal localización es mandibular. Se describe un caso en una paciente femenina de 39 años de edad, con un mixoma odontogénico mandibular en zona parasinfisiaria derecha, asintomática y de tiempo de evolución desconocido. Se llevó a cabo un adecuado diagnóstico, ejecución de plan de tratamiento quirúrgico conservador del caso;, el análisis histopatológico confirmó la presencia de un mixoma odontogénico mandibular. Finalmente, con evolución posoperatoria favorable.

ABSTRACT Mandibular odontogenic myxoma is a benign, recurrent, and locally invasive mesenchymal tumor, its main location is mandibular. A case is described in a 39-year-old female patient with a mandibular odontogenic myxoma in the right parasymphyseal area, asymptomatic, and with an unknown evolution time. An adequate diagnosis was carried out, execution of the case's conservative surgical treatment plan, the histopathological analysis confirmed the presence of a mandibular odontogenic myxoma. Finally, with a favorable postoperative evolution.

ABSTRACT: Ameloblastoma is an aggressive odontogenic tumor classified as unicystic, extraosseous / peripheral, and metastasizing. A 42-year-old woman was attended at the Oral and Maxillofacial Surgery Service due to a 6-month facial asymmetry. Clinically, we observed a volume increase of the left parotid and submandibular region, bulging of the mandibular bone tables and dental mobility. Computed Tomography revealed a cystic-like lesion in the mandibular region. An incisional biopsy and conservative surgical treatment were performed. The histopathological diagnosis was unicystic ameloblastoma, mural pattern. After six months of decompression, a new incisional biopsy and bone curettage were performed, and Carnoy’s solution was applied. Eleven months after the first intervention, bone apposition was observed in the x-ray. The treatment of these ameloblastomas continues to be controversial, so every case should be approached in a unique manner.

RESUMEN: El ameloblastoma es un tumor odontogénico agresivo que se clasifica en uniquístico, extraóseo/periférico y metastatizante. Una mujer de 42 años acudió al Servicio de Cirugía Oral y Maxilofacial por aumento de volumen hemifacial izquierdo de 6 meses de evolución. Al examen se observó aumento de volumen de la región parotídea y submandibular izquierda, abombamiento tablas óseas mandibulares y movilidad dental. La tomografía axial computarizada reveló una lesión de aspecto quístico en la región mandibular. Se realizó la biopsia incisional y el tratamiento quirúrgico conservador. El diagnóstico histopatológico fue ameloblastoma uniquístico patrón mural. Luego de seis meses de descompresión, se realizó una nueva biopsia incisional, curetaje óseo y se aplicó solución de Carnoy. Once meses posteriores a la primera intervención, se constató radiográficamente aposición ósea de la lesión. El tratamiento de estos ameloblastomas continúa siendo controversial por lo que cada caso se debe abordar de manera única.

Resumen El queratoquiste odontogénico es una entidad potencialmente agresiva y de alta recurrencia, con características clínicas y radiográficas no definidas claramente. Se presenta en cualquier etapa de la vida. El 70 a 80% se ubican en la mandíbula, comúnmente en la región de tercer molar y ángulo mandibular desde donde progresan hacia la rama y cuerpo. Son lesiones en general asintomáticas que pueden alcanzar dimensiones notables. A menudo se encuentran en el examen radiográfico de rutina. El objetivo del presente artículo es reportar el caso de una mujer de 40 años de edad, con un queratoquiste odontogénico paraqueratinizado, evaluando sus características clínicas, radiográficas e histopatológicas que llevaron a un manejo y tratamiento conservador oportuno y adecuado con resultados satisfactorios. Concluyendo que la minuciosa elaboración de la historia clínica basado en hallazgos clínicos, radiográficos e histopatológicos conduce a un diagnóstico correcto, que permite la elaboración de un plan de tratamiento adecuado.

Abstract Odontogenic keratocysts are potentially aggressive and have high recurrence rates. Their clinical and radiographic features are not clearly defined. They can occur at any stage of life. Seventy to 80% are located in the mandible, commonly in the area between the third molar and the mandibular angle, from where they grow towards the ramus and body. They are generally asymptomatic lesions that can grow considerably. They are often found on routine radiographs. This paper reports the case of a 40-year-old woman with a parakeratinized odontogenic keratocyst. After assessing the cyst's clinical, radiographic and histopathological features, we managed and treated the condition timely, conservatively, and with satisfactory results. We concluded that preparing the patient's dental history carefully and based on clinical, radiographic, and histopathological findings allowed us to make the correct diagnosis and develop the necessary treatment plan.

Resumo O Queratocisto odontogênico potencialmente agressivo e de alta recorrência, com características clínicas e radiográficas não claramente definidas. Ocorre em qualquer estágio da vida. 70 a 80% estão localizados na mandíbula, geralmente na região do terceiro molar e no ângulo mandibular de onde progridem para o ramo e o corpo. São lesões geralmente assintomáticas que podem atingir dimensões notáveis. Eles são freqüentemente encontrados no exame radiográfico de rotina. O objetivo deste artigo é relatar o caso de uma mulher de 40 anos com um queratocisto odontogênico paraqueratinizado, avaliando suas características clínicas, radiográficas e histopatológicas que conducem ao manejo e tratamento conservador oportuno e adequado, com resultados satisfatórios. Concluindo que o cuidadoso preparo da história médica com base em achados clínicos, radiográficos e histopatológicos leva a um diagnóstico correto, o que permite o desenvolvimento de um plano de tratamento adequado.

Resumo Introdução O tumor odontogênico adenomatoide é uma neoplasia odontogênica relativamente incomum que representa cerca de 4,7% de todos os tumores odontogênicos. Objetivo Determinar o perfil demográfico e clínico dos tumores odontogênicos adenomatoides em uma população do Sri Lanka. Método Os dados foram obtidos dos casos tratados por 38 anos no Departamento de Patologia Oral da Faculty of Dental Sciences, University of Peradeniya. Formulários de solicitação, relatórios de biópsia e o banco de dados eletrônico do departamento foram usados para obter informações relevantes. Dados demográficos, idade, sexo e localização do tumor foram incluídos na análise. Resultados Dos 116 casos de tumor odontogênico adenomatoide, a média de idade foi de 21,02 ± 11,24. Ocorreu com mais frequência na segunda década de vida, e foi mais prevalente no sexo feminino, mais frequentemente associado à maxila, afetou predominantemente os ossos da mandíbula anterior e apresentou-se principalmente no lado direito dos ossos da mandíbula. Os resultados do presente estudo mostraram uma relação estatisticamente significante com o local da ocorrência (maxila/mandíbula) e idade (p < 0,005). Além disso, de acordo com o local de ocorrência, região anterior/média/posterior, também apresentou relação significante com a idade (p ≤ 0,001). Entretanto, nem o lado acometido, direito ou esquerdo, ou o sítio de ocorrência foi estatisticamente significante em relação à idade (p > 0,05). Conclusão O tumor odontogênico adenomatoide ocorre com mais frequência na segunda década de vida, com predominância feminina significativa, e o local mais comum é a maxila anterior. Este estudo revelou poucas diferenças nas apresentações demográficas e clínicas do tumor odontogênico adenomatoide de algumas regiões do mundo.

Abstract Introduction The adenomatoid odontogenic tumor is a relatively uncommon odontogenic neoplasm representing about 4.7% of all odontogenic tumors. Objective The aim of this study was to determine the demographic and clinical profile of the adenomatoid odontogenic tumors in a Sri Lankan population. Methods Data gathered from the cases received for a period of 38 years from the Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya. Request forms, biopsy reports and electronic data base of the department were used to obtain relevant information. Demographic data including age, gender and location of the tumor were included in the analysis. Results Out of 116 cases of adenomatoid odontogenic tumor, the mean age was 21.02 ± 11.24. It occurs more fre quently in the second decade of life, more prevalent in females, most often associated with the maxilla, predominantly affecting anterior jaw bones and presenting mostly in the right side of the jaw bone. The results from the present study showed the statistically significant relationship with site of occurrence (maxilla/mandible) and age (p< 0.005). Further, depending on whether it occurs in anterior/mid/posterior site also showed a significant relationship with age (p≤ 0.001). However, side of occurrence, left or right or site of occurrence, showed no statistically significance with age (p> 0.05). Conclusion Adenomatoid odontogenic tumor occurs more frequently in the second decade of life with a significant female predominance and the commonest site is anterior maxilla. This study revealed few differences on demographic and clinical presentations of adenomatoid odontogenic tumor from some regions of the world.