Introduction: Odontogenic myxoma (OM) is a rare benign odontogenic tumor originating from the periodontal ligament or dental pulp, often associated to MAPK/ERK gene mutation. Radiologically, it usually appears as a radiolucency with variable features, while histologically, it shows a myxoid substance, an absence of epithelial remnants, and collagen deposits. OM may show infiltrative behavior with a recurrence rate of 25%.
The aim of this report is to present a case of odontogenic myxoma localized in the periodontal region of tooth 1.4, from diagnosis to rehabilitation.
Methods: We investigated a 45-year-old female patient presented with a tense–elastic neoformation located in the mucosa corresponding to tooth 1.4. The lesion extended into the vestibular and palatal sides, was non-painful and non-bleeding, and upon probing revealed a pseudo-periodontal pocket measuring 10 mm in depth. A CBCT evaluation was performed to assess the lesion, providing detailed information about its extent and relation to the surrounding structures. Surgical management involved the excision of tooth 1.4 with the lesion, bone curettage using a piezoelectric handpiece, and coronal repositioning of the flap for primary intention healing. The sample was sent for histological examination to the Department of Pathology, leading to the diagnosis of OM. One month after, frenotomy and deepening of the vestibular fornix using diode-laser-assisted surgery (1.5W, CW) were performed. Three months post-surgery, implant rehabilitation was performed. A fully digital workflow was utilized, ensuring precise planning and execution of the treatment.
Results: The follow-up showed no recurrence. The mucosa was restored to a healthy state, and the implant rehabilitation achieved safe, aesthetic, and functional outcomes.
Conclusions: Collaboration between oral surgeon, oral pathologist, pathologist, and prosthodontist was crucial for successful outcomes in similar cases. Furthermore, using the most advanced technologies enabled the rehabilitation with a minimally invasive, accurate, and predictable approach.
