国际口腔医学杂志

国际口腔医学杂志 ›› 2026, Vol. 53 ›› Issue (5): 689-695.doi: 10.7518/gjkq.2026123

• 论著 • 上一篇    

185例牙瘤的临床病理及影像学分析

宋海洋1,2,3(),吴敏2,3,4,江悦2,3,4,戴康2,3,冷迪雅2,3,5,游畅2,3,张雨垚2,3,钟旖2,3,4()   

  1. 1.南京医科大学附属口腔医院综合诊疗科 南京 210029
    2.口腔疾病研究与防治国家级重点实验室培育建设点（南京医科大学） 南京 210029
    3.江苏省口腔转化医学工程研究中心（南京医科大学） 南京 210029
    4.南京医科大学附属口腔医院口腔病理科 南京 210029
    5.南京医科大学附属口腔医院口腔放射科 南京 210029
  • 收稿日期:2025-07-16 修回日期:2025-12-24 出版日期:2026-09-01 发布日期:2026-08-28
  • 通讯作者: 钟旖
  • 作者简介:宋海洋，主治医师，硕士，Email：335929606@qq.com
  • 基金资助:
    国家自然科学基金青年基金(82203580);江苏省医学创新中心(CXZX202227);江苏省卫生健康委员会医学科研项目(M20-20003)

Clinicopathological and radiographic image analysis of 185 cases of odontomas

Haiyang Song1,2,3(),Min Wu2,3,4,Yue Jiang2,3,4,Kang Dai2,3,Diya Leng2,3,5,Chang You2,3,Yuyao Zhang2,3,Yi Zhong2,3,4()   

  1. 1.Dept. of General Dentistry, the Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China
    2.State Key Laboratory Cultivation Base of Research, Prevention and Treatment for Oral Diseases (Nanjing Medical University), Nanjing 210029, China
    3.Jiangsu Province Engineering Research Center of Stomatological Translational Medicine (Nanjing Medical University), Nanjing 210029, China
    4.Dept. of Oral Pathology, the Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China
    5.Dept. of Radiology, the Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China
  • Received:2025-07-16 Revised:2025-12-24 Online:2026-09-01 Published:2026-08-28
  • Contact: Yi Zhong
  • Supported by:
    National Natural Science Foundation of China(82203580);Jiangsu Provincial Medical Innovation Center(CXZX202227);Medical Research Project of Jiangsu Provincial Health Commission(M2020003)

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摘要：

目的 分析牙瘤的临床特征、影像学表现及病理学特点，为临床诊断和治疗提供参考依据。 方法 回顾性分析2019年1月至2024年12月南京医科大学附属口腔医院185例经病理诊断为牙瘤患者资料，包括临床表现、病理学结果及锥形束CT（CBCT）影像学特征。 结果 患者的平均年龄17.4岁，中位年龄13岁，男女比例为97∶88。组合性牙瘤114例，混合性牙瘤71例（含发育期混合性牙瘤3例），组合性牙瘤患者年龄显著小于混合性牙瘤患者（P=0.009）。病变区域以上颌骨为主（60.5%，112/185），其中组合性牙瘤多见于上颌前牙区（58.8%，67/114），混合性牙瘤主要分布于上颌前牙区（40.8%，29/71）及下颌磨牙区（21.1%，15/71）。70.3%（130/185）的患者存在牙齿萌出异常，主要包括恒牙阻生、迟萌及乳牙滞留。22.7%（42/185）的患者伴发其他牙源性病变，主要为牙源性钙化囊肿（11.4%，21/185）和含牙囊肿（9.7%，18/185）。 结论 牙瘤好发于青少年，组合性牙瘤发病年龄早于混合性牙瘤。2种类型牙瘤的解剖分布存在差异，对邻近牙齿的萌出均产生显著影响。牙瘤与牙源性钙化囊肿、含牙囊肿具有较高共存率，临床治疗时应彻底清除周围囊壁组织，同时注重保护邻近牙齿结构的完整性。

关键词: 牙瘤, 临床病理, 影像学分析

Abstract:

Objective This study aims to analyze the clinical characteristics, imaging findings, and pathological features of odontomas and to provide a reference for their clinical diagnosis and treatment. Methods A re-trospective analysis was conducted on the data of 185 patients diagnosed with odontomas in the Nanjing Medical University Affiliated Stomatological Hospital from January 2019 to December 2024. The data included clinical manifestations, pathological results, and cone beam computed tomography (CBCT) imaging features were collected and analyzed. Results he mean age of the patients was 17.4 years, and the median age was 13 years. The male-to-female ratio was 97∶88. Among the cases, 114 were compound odontomas and 71 were complex odontomas (including three developing complex odontomas). Patients with compound odontomas were significantly younger than those with complex odontomas (P=0.009). The lesions were predominantly located in the maxilla (60.5%, 112/185), and compound odontomas were commonly found in the maxillary anterior region (58.8%, 67/114). Complex odontomas were primarily distributed in the maxillary anterior (40.8%, 29/71) and mandibular molar regions (21.1%, 15/71). Dental eruption abnormalities were present in 70.3% (130/185) of patients, primarily including impacted permanent teeth, delayed eruption, and retained deciduous teeth. Additionally, 22.7% (42/185) of the patients had concurrent odontogenic lesions, which were primarily odontogenic calcifying (11.4%, 21/185) and dentigerous cysts (9.7%, 18/185). Conclusion Odontomas predominantly affect adolescents, and compound odontomas occur at an earlier age than complex odontomas. The two types exhibit differences in anatomical distribution but both considerably affect the eruption of adjacent teeth. Odontomas show a high coincidence rate with odontogenic calcifying and dentigerous cysts. Thus, clinical treatment should include the thorough removal of surrounding cystic wall tissues while preserving the integrity of adjacent dental structures.

Key words: odontoma, clinicopathology, imaging analysis

中图分类号: 

  • R739.82

表 1

牙瘤患者性别及年龄分布"

性别年龄/岁
0~910~1920~2930~3940~4950~5960~69
合计28924213442
男1548246121
女1344187321

表 2

组合性及混合性牙瘤患者年龄分布"

病理类型年龄/岁
0~910~1920~2930~3940~4950~5960~69
合计28924213442
组合性2354248221
混合性538185221

表 3

185例牙瘤病变区域分布"

病理类型病例总数上颌骨下颌骨
前牙区前磨牙区磨牙区前牙区前磨牙区磨牙区
合计1859697441118
组合性11467423173
混合性71295513415

图 1

牙瘤伴发不同牙源性病变 HE ×10A：牙瘤伴发含牙囊肿；B：牙瘤伴发牙源性钙化囊肿；C：牙瘤伴发成釉细胞瘤；D：牙瘤伴发牙本质生成性影细胞瘤。"

表 4

牙瘤伴随病变情况分析"

病变类型组合型牙瘤混合型牙瘤
合计2121
含牙囊肿126
牙源性钙化囊肿912
成釉细胞瘤02
牙本质生成性影细胞瘤01

图 2

牙瘤误诊为牙源性钙化囊肿患者CBCT影像A：水平位；B：矢状位；C：曲面位。箭头指向牙瘤。"

图 3

恒牙列、替牙列及乳牙列牙瘤患者CBCT影像A：恒牙列牙瘤水平及矢状面影像；B：替牙列牙瘤水平及矢状面影像；C：乳牙列牙瘤水平及矢状面影像。箭头指向牙瘤。"

图 4

牙瘤伴多生牙患者CBCT影像A、B：水平面；C、D：矢状面；E：三维成像。白色箭头指向牙瘤，红色箭头指向多生牙。"

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