We read with some surprise a clinical report by Erdur et al in the June 2016 issue of the AJO-DO . The authors presented a textbook case of adenomatoid odontogenic tumor (AOT), claiming that “this case report is the first to report on the eruption of an impacted canine in an adenomatoid odontogenic tumor treated with combined orthodontics and marsupialization.” Since this therapy for AOT is both well documented and well established, it is difficult to accept this statement. The authors appeared to be unaware of the many previous reports documenting active orthodontic therapy for AOT after surgical exposure, a representative sample of which are presented chronologically in our reference list. Although these English-language papers would have appeared in most computerized literature searches, oddly, all seem to have escaped the attention of Erdur et al.
The authors also concluded that marsupialization has never been used as a treatment option for an AOT, and further prospective studies with more patients are needed before recommending marsupialization as a treatment option for AOT. It has long been recognized that subtotal excision (marsupialization) can be successfully applied for the treatment of AOT. In the previously reported cases, this conservative procedure resulted in complete bone healing and facilitated spontaneous eruption of the impacted tooth or teeth. The third series of the Armed Forces Institute of Pathology atlas written 15 years ago stated that “in appropriate circumstances, it may be possible to preserve the involved tooth.” This view has been reiterated in more contemporary standard texts. Of additional interest was a report of reimplantation of a developing AOT-related tooth, although this is not a preferred treatment. According to that report, no tumor recurrence was evident 4 years after surgery, and the involved mandibular first molar continued to erupt spontaneously, showing completion of root formation and reaching the occlusal plane. It is now 50 years since Philipsen and Birn first reported a case of AOT treated by marsupialization and orthodontic treatment. This type of combined therapy has since become popularized and is now accepted worldwide. The present single case report should merely serve to confirm and validate the above studies, one of which, previously unrecognized by the authors, was published with a comparable title in the AJO-DO .
In summary, the steady stream of reports on orthodontic-guided eruption of the tooth or teeth associated with AOT conclusively indicates that the treatment modality described by Erdur et al is nothing new and in fact is rather standard. Furthermore, the term AOT was first coined by Philipsen and Birn in 1969 and not by the World Health Organization in 1971. It is always prudent to avoid claims of first description if authors are not sufficiently familiar with the work of experts in the field. In addition to our surprise that the authors’ survey of the AOT literature was insufficient, we are puzzled that reviewers for this reputable journal who accepted the article for publication were unaware that the reported case was unremarkable and the authors’ claim quite without merit.
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