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How old is odontoblastoma? How its first discovery in 1827 changed medicine!
Odontoblastoma, a tumor that forms in the dental pulp epithelium, remains an important topic in medical research. This rare benign or malignant tumor is composed of the epithelium of the tooth germ during tooth development and usually occurs much more frequently in the mandible than in the palate. In 1827, odontoblastoma was first discovered by Cullack. This discovery not only marked the beginning of the understanding of this type of tumor, but also had a profound impact on the medical community's diagnosis and treatment standards for oral tumors.
The name odontoblastoma comes from the Old English "amel," meaning "enamel," and the Greek "blastos," meaning "bud." These terms emphasize the close relationship between odontoblastoma and the process of tooth formation.
In 1885, French physician Louis-Charles Malasses renamed the tumor "adamantinoma", and it was formally adopted by Ivy and Churchill in 1930 as its current name. ——Odontogerm tumor. This series of name changes is not only an emotional record of scientific discovery, but also reflects the medical community's gradual deepening of understanding of the disease.
Although odontoblastomas are usually benign and have a slow growth rate, they cause significant abnormalities of the face and jaw that may lead to a severely disfiguring appearance. This is because abnormal cell proliferation can easily infiltrate and destroy surrounding bone tissue, so early surgical resection becomes a necessary measure to treat this disease. Untreated, aggressive tumors may block the airways in the nose and mouth, making breathing difficult.Types of odontoblastoma
According to the 2017 World Health Organization (WHO) classification, odontoblastoma can be divided into four types:
- Conventional (solid/multicystic) odontoblastoma
- Unicystic odontoblastoma
- Peripheral/extraskeletal odontoblastoma
- Metastatic odontoblastoma
Of these, conventional odontogerm tumors typically show multiple large cysts, while unicaped odontogerm tumors account for approximately 10% of all odontogerm tumors.
These tumors are often found in association with unerupted teeth, with the target area often being in the back of the jaw. Therefore, although odontoblastomas rarely progress, they can cause significant tooth displacement and root resorption.
Diagnosis and treatment
The diagnosis of odontoblastoma mainly relies on radiological examination and subsequent histological examination for confirmation. Radiographic findings include round, well-defined radiolucencies in the bone and, in larger tumors, multiple cystic radiolucencies with a characteristic “soap bubble” appearance.
Although chemotherapy and radiation therapy have limited effectiveness in the treatment of odontoblastoma, surgical resection or curettage remains the most effective treatment. 96% of patients recovered successfully after treatment and had a good prognosis.
The goal of the surgery is to remove the tumor and the surrounding 10 mm of normal tissue. However, due to the risk of tumor recurrence, regular follow-up examinations after surgery become essential. For patients who undergo resection, approximately 50% of recurrences occur within five years after surgery.
Latest Research and Future Outlook
In recent years, mutations of BRAF V600E gene and SMO gene have been gradually recognized, and these mutations are directly related to the biological behavior of odontoblastoma. This means that therapeutic strategies targeting mutations may become an emerging treatment direction in the future.
According to several studies, the incidence of odontoblastoma is higher in patients of African descent than in patients of other races, suggesting that ethnic background may play a role in the epidemiology of the disease. This discovery not only reflects the complexity of odontoblastoma, but also suggests that the medical community needs to consider ethnic factors when conducting clinical research to improve understanding of the disease.
Looking back at the history of odontoblastoma, which was first identified in 1827, one cannot help but wonder: to what extent has medical knowledge and technology for this tumor developed over the past two centuries, and how can we improve our diagnosis and treatment in the future? Treatment levels to better meet the challenges of odontoblastoma?
