Ameloblastomas mimicking apical periodontitis: a case series

Giuliana Soimu, J. Netto, Á. Miranda, D. Perez, L. Armada, F. Pires
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Abstract

Background Ameloblastomas are benign odontogenic tumors that can eventually mimic the clinical and radiological features of apical periodontitis. The aim of the present study was to evaluate the clinical, radiological and histological characteristics from a series of ameloblastomas mimicking apical periodontitis diagnosed in a 14-year period. Material and Methods all cases histologically diagnosed as ameloblastomas from 2005 to 2018 presenting a clinical diagnosis of periapical lesion of endodontic origin were selected for the study. Clinical, radiological and histological characteristics from all cases were tabulated and descriptively and comparatively analyzed. Results Twenty cases composed the final sample, including 18 solid and 2 unicystic ameloblastomas. Mean age of the affected patients was in the fifth decade with predilection for males (72%). The most common anatomical location was the posterior mandible (55%) and most cases presented a radiolucent unilocular (80%) well-defined (95%) image. Most cases were asymptomatic, but the presence of local swelling and bone cortical rupture were common. Conclusions Ameloblastomas mimicking periapical lesions of endodontic origin are mostly diagnosed in adult males as well-defined radiolucent unilocular lesions producing local swelling and bone cortical rupture. Key words:Ameloblastoma, apical periodontitis, cyst, differencial diagnosis, granuloma, periapical lesion.
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模拟根尖牙周炎的成釉细胞瘤:一个病例系列
成釉细胞瘤是一种良性牙源性肿瘤,其临床和放射学特征最终与根尖牙周炎相似。本研究的目的是评估临床,影像学和组织学特征,从一系列的成釉细胞瘤模拟根尖牙周炎诊断在14年期间。材料与方法本研究选择2005 ~ 2018年组织学诊断为成釉细胞瘤,临床诊断为根管源性根尖周病变的病例。将所有病例的临床、放射学和组织学特征制成表格,进行描述和比较分析。结果最终标本共20例,其中实性成釉细胞瘤18例,单囊性成釉细胞瘤2例。受影响患者的平均年龄在50岁左右,男性居多(72%)。最常见的解剖位置是后下颌骨(55%),大多数病例呈现透光的单眼图像(80%),清晰的图像(95%)。大多数病例无症状,但存在局部肿胀和骨皮质破裂是常见的。结论成釉细胞瘤与根管起源的根尖周围病变相似,在成年男性中多被诊断为界限分明、透光的单眼病变,并伴有局部肿胀和骨皮质破裂。关键词:成釉细胞瘤,根尖牙周炎,囊肿,鉴别诊断,肉芽肿,根尖周围病变。
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