上海口腔医学 ›› 2025, Vol. 34 ›› Issue (5): 557-560.doi: 10.19439/j.sjos.2025.05.019

• 病例报告 • 上一篇    

下颌骨巨大混合性牙瘤伴感染1例报告及文献复习

侯承素1,*, 张于涵2,*, 王婕妤2, 史敬存2, 张冰清2, 王磊1,2   

  1. 1.上海市奉贤区奉城医院 口腔颌面-头颈肿瘤科,上海 201411;
    2.上海交通大学医学院附属第九人民医院 口腔颌面-头颈肿瘤科, 上海交通大学口腔医学院, 国家口腔医学中心, 国家口腔疾病临床医学研究中心, 上海市口腔医学重点实验室, 上海市口腔医学研究所,上海 200011
  • 收稿日期:2025-04-07 修回日期:2025-05-22 出版日期:2025-10-25 发布日期:2025-10-31
  • 通讯作者: 王磊,E-mail: wangleizyh@aliyun.com
  • 作者简介:侯承素(1991-),男,硕士,主治医师,E-mail:523407825@qq.com;张于涵(1998-),男,在读博士研究生,E-mail:zhangyuhan19980323@163.com。*并列第一作者
  • 基金资助:
    上海市卫生健康委员会科研项目(202340135)

Giant complex odontoma with infection of mandible: a case report and literature review

Hou Chengsu1, Zhang Yuhan2, Wang Jieyu2, Shi Jingcun2, Zhang Bingqing2, Wang Lei1,2   

  1. 1. Department of Oromaxillofacial Head and Neck Oncology, Fengcheng Hospital. Shanghai 201411;
    2. Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth Peoples' Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology. Shanghai 200011, China
  • Received:2025-04-07 Revised:2025-05-22 Online:2025-10-25 Published:2025-10-31

摘要: 下颌骨巨大混合性牙瘤是一种较为罕见的牙源性肿瘤,本文报告1例42岁男性患者,结合相关文献对其下颌骨巨大混合性牙瘤伴感染的临床诊疗过程进行讨论。混合性牙瘤通常生长缓慢且无明显症状,但巨大牙瘤(直径>3 cm)可能导致牙移位、颌骨膨隆甚至感染。本病例的特殊性在于牙瘤突破口腔黏膜引发局部感染,增加了临床诊治的复杂性。手术切除是主要治疗方式,但巨大牙瘤需警惕术中损伤下牙槽神经、血管及术后颌骨骨折的风险。混合性牙瘤的萌出机制可能与骨质吸收或埋伏牙的推动有关,但其确切机制仍需进一步研究。早期诊断和精准手术可有效预防下颌骨巨大混合性牙瘤感染及颌骨病理性骨折,改善预后。

关键词: 牙源性肿瘤, 混合性牙瘤, 下颌骨, 手术切除

Abstract: Giant complex odontoma of the mandible is a relatively rare odontogenic tumor. This article reported the clinical diagnosis and treatment process of a 42-year-old male patient with a giant complex odontoma in the left mandible accompanied by infection, along with a discussion based on relevant literature. Complex odontomas typically were asymptomatic and grew slowly, but giant odontomas (diameter >3 cm) may cause tooth displacement, mandibular swelling, or even infection. The uniqueness of this case lies in the odontoma penetrating the oral mucosa, leading to localized infection, which increased the complexity of clinical management. Surgical excision was the primary treatment for giant odontomas, and cautions must be taken to avoid intraoperative damage to the inferior alveolar nerve and blood vessels, as well as postoperative mandibular fractures. The eruption mechanism of complex odontomas may be related to bone resorption or the pushing force of impacted teeth, though the exact mechanism requires further investigation. This case highlights that early diagnosis and precise surgical intervention for giant mandibular complex odontomas can effectively prevent infection and pathological fractures, thereby improving prognosis.

Key words: Odontogenic tumor, Complex odontoma, Mandible, Surgical removal

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