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Er:YAG Laser Assisted Treatment of Central Odontogenic Fibroma of the Mandible.

Monteiro LS, Martins M, Pacheco JJ, Salazar F, Magalhães J, Vescovi P, Meleti M - Case Rep Dent (2015)

Bottom Line: A conservative excision using Er:YAG laser was performed.There were no postoperative complications.No recurrence was observed during follow-up.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine and Oral Surgery, Higher Institute of Health Sciences (ISCS-N), CESPU, 4585-116 Paredes, Portugal ; Institute of Research and Advanced Training in Health Sciences and Technologies (IINFACTS), Higher Institute of Health Sciences (ISCS-N), CESPU, 4585-116 Paredes, Portugal ; Stomatology and Dental Medicine Department, Centro Hospitalar de São João, Polo de Valongo, 4440-563 Valongo, Portugal.

ABSTRACT
Central odontogenic fibroma is a very rare benign odontogenic tumour characterized by a fibrous mature stroma with variable strands or islands of inactive-looking odontogenic epithelium. Our aim is to report a case of a central odontogenic fibroma and describe the clinical usefulness of Er:YAG laser for the surgical treatment of this tumour. A 74-year-old woman presented with an expansive lesion located in a mandible with multilocular and mixed radiographic appearance. A conservative excision using Er:YAG laser was performed. Complete removal was obtained. There were no postoperative complications. The histopatologic features were consistent with the diagnosis of central odontogenic fibroma of rich-epithelium type. No recurrence was observed during follow-up.

No MeSH data available.


Related in: MedlinePlus

(a) Microscopic view of the lesion demonstrating the presence of fibroblastic and collagenous tissue with many strands of odontogenic epithelial cells and focally calcified foci resembling osteoid and cementoid material (H&E stain ×100 magnification). (b) Odontogenic epithelial nests without cytological atypia in a fibroblastic and collagenous stroma with hyaline areas (H&E stain ×200 magnification).
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fig3: (a) Microscopic view of the lesion demonstrating the presence of fibroblastic and collagenous tissue with many strands of odontogenic epithelial cells and focally calcified foci resembling osteoid and cementoid material (H&E stain ×100 magnification). (b) Odontogenic epithelial nests without cytological atypia in a fibroblastic and collagenous stroma with hyaline areas (H&E stain ×200 magnification).

Mentions: Extraction of 37, 36, 35, and 34 was performed and a bioptic specimen of the lesion was obtained under local anaesthesia (2% lidocaine with 1 : 100,000 epinephrine). Histopathological evaluation showed a lesion composed of a fibroblastic/collagenous tissue with many strands or nests of odontogenic epithelial cells without cytological atypia. Focally prominent hyaline calcified foci, resembling osteoid and dentinoid material, were also present (Figure 3). Such features favoured the diagnosis of a central odontogenic fibroma. After one month, the patient underwent the excision of the lesion under local anaesthesia using Er:YAG (2940 nm) laser for bone osteotomy (Figure 4). We used a Deka Smart 2940 Plus laser, with articulated arm, with an angulated mirror hand piece, 1 mm of spot, on a short-pulse mode, 15 Hz, 300 mJ, 4.5 W output power, power density of 573.25 W/cm2, and fluence of 38.22 J/cm2. During the excision, we observed that the lesion was almost encapsulated except at its inferior margin with a more ill-defined border. Because of this, additionally to the enucleation and curettage of the lesion, a peripheral osteotomy was performed until clear bone tissue was obtained to ensure complete elimination of the tumour. There were no postoperative complications such as pain, paresthesia, and swelling one week after surgery. Histopathologic examination of the whole specimen confirmed the diagnosis of central odontogenic fibroma, epithelium-rich type (complex or WHO type). No recurrence was seen at the follow-up visits (Figure 5) during a period of 4 years.


Er:YAG Laser Assisted Treatment of Central Odontogenic Fibroma of the Mandible.

Monteiro LS, Martins M, Pacheco JJ, Salazar F, Magalhães J, Vescovi P, Meleti M - Case Rep Dent (2015)

(a) Microscopic view of the lesion demonstrating the presence of fibroblastic and collagenous tissue with many strands of odontogenic epithelial cells and focally calcified foci resembling osteoid and cementoid material (H&E stain ×100 magnification). (b) Odontogenic epithelial nests without cytological atypia in a fibroblastic and collagenous stroma with hyaline areas (H&E stain ×200 magnification).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4592713&req=5

fig3: (a) Microscopic view of the lesion demonstrating the presence of fibroblastic and collagenous tissue with many strands of odontogenic epithelial cells and focally calcified foci resembling osteoid and cementoid material (H&E stain ×100 magnification). (b) Odontogenic epithelial nests without cytological atypia in a fibroblastic and collagenous stroma with hyaline areas (H&E stain ×200 magnification).
Mentions: Extraction of 37, 36, 35, and 34 was performed and a bioptic specimen of the lesion was obtained under local anaesthesia (2% lidocaine with 1 : 100,000 epinephrine). Histopathological evaluation showed a lesion composed of a fibroblastic/collagenous tissue with many strands or nests of odontogenic epithelial cells without cytological atypia. Focally prominent hyaline calcified foci, resembling osteoid and dentinoid material, were also present (Figure 3). Such features favoured the diagnosis of a central odontogenic fibroma. After one month, the patient underwent the excision of the lesion under local anaesthesia using Er:YAG (2940 nm) laser for bone osteotomy (Figure 4). We used a Deka Smart 2940 Plus laser, with articulated arm, with an angulated mirror hand piece, 1 mm of spot, on a short-pulse mode, 15 Hz, 300 mJ, 4.5 W output power, power density of 573.25 W/cm2, and fluence of 38.22 J/cm2. During the excision, we observed that the lesion was almost encapsulated except at its inferior margin with a more ill-defined border. Because of this, additionally to the enucleation and curettage of the lesion, a peripheral osteotomy was performed until clear bone tissue was obtained to ensure complete elimination of the tumour. There were no postoperative complications such as pain, paresthesia, and swelling one week after surgery. Histopathologic examination of the whole specimen confirmed the diagnosis of central odontogenic fibroma, epithelium-rich type (complex or WHO type). No recurrence was seen at the follow-up visits (Figure 5) during a period of 4 years.

Bottom Line: A conservative excision using Er:YAG laser was performed.There were no postoperative complications.No recurrence was observed during follow-up.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine and Oral Surgery, Higher Institute of Health Sciences (ISCS-N), CESPU, 4585-116 Paredes, Portugal ; Institute of Research and Advanced Training in Health Sciences and Technologies (IINFACTS), Higher Institute of Health Sciences (ISCS-N), CESPU, 4585-116 Paredes, Portugal ; Stomatology and Dental Medicine Department, Centro Hospitalar de São João, Polo de Valongo, 4440-563 Valongo, Portugal.

ABSTRACT
Central odontogenic fibroma is a very rare benign odontogenic tumour characterized by a fibrous mature stroma with variable strands or islands of inactive-looking odontogenic epithelium. Our aim is to report a case of a central odontogenic fibroma and describe the clinical usefulness of Er:YAG laser for the surgical treatment of this tumour. A 74-year-old woman presented with an expansive lesion located in a mandible with multilocular and mixed radiographic appearance. A conservative excision using Er:YAG laser was performed. Complete removal was obtained. There were no postoperative complications. The histopatologic features were consistent with the diagnosis of central odontogenic fibroma of rich-epithelium type. No recurrence was observed during follow-up.

No MeSH data available.


Related in: MedlinePlus