BURAK CEZAİRLİ, Fatih TAŞKESEN, Ümmügülsüm ÇOŞKUN, Neslihan Seyhan CEZAİRLİ, EMRE TOSUN

Surgical Treatment of a Large Complex Odontoma

Odontomaların tedavi yöntemleri genellikle tümör boyutuna bağlıdır. Küçük ve orta boyuttaki lezyonlar genellikle çevredeki anatomik yapılara zarar vermeden kolaylıkla çıkarılabilir. Çalışmamızda dev bir odontomanın konservatif bir şekilde cerrahi tedavisi ele alınmaktadır. On dokuz yaşındaki kadın hasta, sağ mandibular angulusta radyolojik muayene sırasında fark edilen bir lezyon sonrasında kliniğimize sevk edildi. Hasta, muayene esnasında semptomsuzdu. Bilgisayarlı tomografi (BT) görüntüleri 3,5 cm x 3 cm x 2 cm boyutlarında bir kitleyi gösterdi. BT kesitleri ve üç boyutlu görüntülerde kısmen aşınmış bukkal ve lingual korteks görüldü. Kompound odontoma tanısı koyulan lezyonun cerrahi yaklaşımla tedavi edilmesine karar verildi. Bukkal ve lingual kortekslerin kırığı önlemede yeterli kalınlıkta olduğu olguda freze edilerek parçalar halinde uzaklaştırılan lezyon sonrasında maksillo-mandibular fiksasyon (MMF) gibi yöntemlerin gerekli olmadığı düşünüldü. Bizim olgumuzda, odontomun büyüklüğü konservatif bir tedavi yöntemi için olmasıyla beraber hem olası bir fraktür önlemiş hem de MMF'nin dezavantajlarını ortadan kaldırılmıştır.

Dev Kompleks Odontomanın Cerrahi Tedavisi

The treatment modalities for odontomas are generally depend on the tumors size. Small and medium lesions can usually be removed easily allowing preservation of surrounding anatomical structures. In our study, we reported a conservative surgical treatment of a large complex odontoma. A 19-year-old woman was referred to our clinic after an incidentally observed lesion on her right mandibular angle. The patient was symptom-free at the time of visit. Computed tomography (CT) images showed a mass with a size of 3.5 cm x 3 cm x 2 cm. CT sections and tridimensional images showed partially eroded buccal and lingual cortex. Surgical treatment was indicated with an initial diagnosis of compound odontoma. The lesion removed after sectioning with bur and maxillo-mandibular fixation (MMF) were not thought to be necessary while the buccal and lingual cortexes were mostly reliable for preventing a fracture.In our case, the size of the odontoma was suitable for a conservative treatment method and with this modality we managed to prevent a possible fracture and eliminate the disadvantages of MMF.

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