From Big Medical Encyclopedia

ODONTOMA (odontoma; Greek odus, odontos tooth + oma) — the rare benign dontogenous tumor consisting of various tooth fabrics. The lake can be located on top and bottom jaws, is more often — in the field of premolar tooths and painters.

Distinguish soft and firm O. Myagkaya O. is formed by epithelial growths and gently fibrous connecting fabric. In some cases the connective tissue component differs in low degree of a differentiation of cells that is combined with the infiltrative growth of a tumor. In tumoral fabric rudiments can be quite often found teeth (see). Firm O. is usually covered with the coarse-fibered capsule and consists of firm elements of tooth, a pulp and a periodontium. Typical localization of firm O. is the corner or a branch of a mandible (see. Jaws ), but sometimes it meets also in an upper jaw. The originality gistol, firm O.'s structures is caused by various ratio, unequal degree of a maturity and calcification of the fabrics making a tumor. Depending on features of a structure among firm O. distinguish simple, difficult and cystous. Simple O. develops from fabrics of one dental germ, differs from tooth in disturbance of topographical ratios of enamel, dentine, cement. Difficult O. is formed by a conglomerate of teeth or zubopodobny fabrics. Cystous O. is presented by a follicular cyst, in a cavity the cut is defined by zubopodobny educations.

On a wedge, soft O. reminds manifestations adamantinoma (see), but unlike it meets preferential aged up to 20 years. At the beginning of a disease note uniform or hilly swelling of a jaw. In process of further growth the tumor destroys cortical substance of a jaw and burgeons in surrounding soft tissues. In an oral cavity find the hilly easily bleeding tumor of a myagkoelastichesky consistence of cyanotic color. Infection of a mucous membrane leads to its ulceration and development hron, inflammations in soft tissues and a bone. As a result hron, inflammations with periodic aggravations in an oral cavity or submaxillary area (a submandibular triangle, T.) fistulas with purulent separated form. Acute inflammatory process around O. is combined with the phenomena of lymphadenitis regional limf, nodes (see. Lymphadenitis ). Firm O. differs in slow expansive growth and develops in the period of formation of second teeth. When O. reaches a certain size, process is stabilized and the tumor obyzvestvlyatsya completely.

Carry to firm O. also a dentinoma, the rare benign tumor consisting preferential of dentine and unripe connecting fabric.

Fig. 1. The roentgenogram of a part of a mandible at an odontoma: an intensive shadow of a large tumor (it is specified by shooters) with accurate hilly contours.
Fig. 2. The intra oral roentgenogram of a part of a mandible at a difficult odontoma of its front department: shooters specified the tumor consisting of zubopodobny formations of various size.

For the purpose of establishment of the diagnosis conduct rentgenol, and morfol, researches. At rentgenol, a research O. has an appearance of an intensive shadow with accurate hilly contours (fig. 1) and a strip of an osteoporosis on the periphery. Sometimes against the background of a shadow of a tumor zubopodobny educations are visible irregular shape. On difficult O.'s roentgenogram zubopodobny formations of various size (fig. 2), as a rule, are defined; nek-ry of them have the form of correctly created teeth. Emergence of inflammatory process changes rentgenol, a picture — the structure of a surrounding bone tissue becomes indistinct, the fistular courses can be visible. The final diagnosis is established at gistol. a research of the material taken from a tumor in the way biopsies (see).

Treatment operational. The tumor which is located in the thickness of an alveolar shoot is deleted, using intra oral access; at O. located in the field of a corner or a branch of a mandible extraoral access is shown. The bathing soft O. which is expansive growing highly diff rentsiro is carefully enucleated, and then delete sites of a bone tissue, adjacent to a tumor. Concerning soft O. with dominance of the low-differentiated cellular elements and infiltrative growth the resection of a jaw is shown (see. Jaws ), to-ruyu carry out within healthy fabrics. Firm O. is deleted together with the capsule, and the bed it is scraped out. At completely calciphied O. without signs hron, inflammations and funkts, disturbances operational treatment is usually not shown.

Forecast favorable.

See also Dontogenous tumors .

Bibliography: Yermolaev I. I. and JI and - Nyuk S. V. Soft odontomas, in book: Theory and practice stomatol., under the editorship of JI. I. Falina, century 7, page 209, M., 1963; Zedgenidze G. A. and Shilova-Mekhanik R. S. Radiodiagnosis of diseases of teeth and jaws, page 211, M., 1962; The Guide to pathoanatomical diagnosis of tumors of the person, under the editorship of N. A. Krayevsky and A. V. Smolyanni-kov, page 129, M., 1976; The Guide to surgical stomatology, under the editorship of A. I. Evdokimov, page 371, M., 1972; III e x t of e r I. A., Vorobyov Yu. I. and Kotelnikov M. V. The atlas of roentgenograms of teeth and jaws is normal also of pathology, page 140, M., 1968; With about 1 b at R. And., To e of of D. A. a. Robinson H. Century of G. Color atlas of oral pathology, p. 44, Philadelphia — Montreal, 1961; Gorlin R. J., Chaudh-r y A.P. Pindborg J. J. Odontogenic tumors, Cancer, v. 14, p. 73, 1961.

A. I. Paches, O. M. Maximova; Yu. I. Vorobyov (rents.).