Clinical observations of odontomas in Japanese children: 39 cases including one recurrent case

Mandibular Odontogenic Tumors That Caused Delayed Eruption of the First Molar: A Case Report of Two Patients

Delayed eruption of permanent teeth during the replacement period is relatively common in clinical practice; however, impaction of the mandibular first molar is rare. There are various causes of delayed eruption of permanent teeth such as odontogenic cysts and tumors. This article describes the management of two odontogenic tumors that caused the delayed eruption of the mandibular first molar. In Case 1, an eight-year-old boy was diagnosed with an unerupted right mandibular first and second molar that had an odontogenic tumor around them. Radiographic examination revealed well-defined unilocular radiolucency with impacted first and second molars and scattered radiographic opaque images at the right mandibular. The lesion was completely curettaged with extraction of the second molar, and the first molar was fenestrated. Pathological microscopic examination provided the diagnosis as an ameloblastic fibro-odontoma. In Case 2, an 11-year-old boy was diagnosed with an unerupted right mandibular first molar that had an odontogenic tumor around it. Radiographic examination revealed well-defined unilocular radiolucency with an impacted first molar and scattered radiographic opaque images at the right mandibular The lesion was completely curretaged, and the first molar was fenestrated. Pathological microscopic examination provided the diagnosis of odontoma. Among these two cases, the preserved first molar erupted at each regular position. We demonstrated that even if an odontogenic tumor is present along with an impacted molar, removal of the tumor can result in the eruption of the impacted tooth.

Odontoma Recurrence. The Importance of Radiographic Controls: Case Report with a 7-Year Follow-Up

Odontomas are benign tumors characterized by slow and limited growth with a rare recurrence. Odontomas are generally detected by radiographic findings in the radiopaque stage, where calcification of the tissues is observed. This article seeks to report the recurrence of a radiologically diagnosed odontoma to show the importance of radiographic controls after enucleation as a diagnostic and follow-up method. Case report: A female patient, 9 years old, attended dental care in 2020 due to malpositioned teeth. In the intraoral clinical examination, she presented stage II mixed dentition with crowding. A radiographic exam showed no associated lesions. The patient reported a history of odontoma removal and a supernumerary tooth in sextant II in 2016. Subsequently, she was referred to orthodontics, where permanent dentition with moderate anterior crowding in the maxilla and mandible was observed. The radiographic examination showed a radiopaque area compatible with odontoma, palatal to teeth 12 and 13. Conclusions: Although recurrence is rare, complete removal in the case of an odontoma is critical. This study demonstrates the importance of performing radiographic controls 5 years after enucleation of an odontoma, considering the stages of evolution.

Spontaneous Eruption of Permanent Teeth That Had Eruption Disturbances After Extirpation of Odontomas: A Report of Two Cases

Odontomas, often found adjacent to impacted teeth, are tumors of abnormal tissue morphology arising from the tooth germ and are usually asymptomatic. They are often found by accident on X-ray images, and the eruption of permanent teeth is often caused by odontomas. In most cases, the tooth is extracted with the permanent tooth or orthodontic treatment is performed after extraction. However, the criteria are not clear. We encountered two cases of dental eruption in which permanent teeth, which originally seemed to be suitable for orthodontic treatment, spontaneously erupted after odontoma removal. It is necessary to examine the indications and timing of tooth extraction.

Complex odontoma: A single center case series

Odontoma is a benign mixed odontogenic tumor. Odontoma is classified into two variants: compound odontoma, which has resemblance to the tooth structure, and complex odontoma, which consists of haphazardly arranged enamel and dentin bearing no resemblance to the tooth structure. The most common site of occurrence of complex odontoma is the posterior aspect of mandible. Surgical excision of the complex odontoma remains the mainstay of treatment, which seldom recurs. Here, we report a series of complex odontoma cases reported to our institute that were managed by surgical excision with no signs of recurrence in subsequent follow-up appointments.

Pediatric Odontogenic Tumors

Odontogenic tumors are rare tumors of the jaws that arise from remnants of the tooth forming apparatus. Some odontogenic tumors demonstrate strong predilection for pediatric patients including the unicystic ameloblastoma, adenomatoid odontogenic tumor, ameloblastic fibroma, ameloblastic fibro-odontoma, odontoma, and primordial odontogenic tumor. In this review, we discuss the clinical, radiographic, histopathologic, and molecular characteristics of select odontogenic tumors that demonstrate pediatric predilection and review management.

Clinical and radiological characteristics of odontomas: A retrospective study of 90 cases

PURPOSE

Odontomas represent a common clinical entity among odontogenic tumors, but are not well-addressed in the Vietnamese population. The present study aimed to determine the clinical and preclinical characteristics of odontomas and associated factors in the Vietnamese population.

MATERIALS AND METHODS

This retrospective study retrieved data from histopathological diagnoses from 2 central hospitals of Odonto-Stomatology in Ho Chi Minh City, Vietnam during 2004-2017. The odontomas were classified as complex (CxOD) or compound (CpOD) subtypes. The epidemiological, clinical, and radiological characteristics of the odontomas, stratified by subtype and sex, were obtained and analyzed.

RESULTS

Ninety cases, consisting of 46 CxODs and 44 CpODs, were included. The average age of patients was 32.4 (±20.2) years. The patients with CxOD were older than those with CpOD (P<0.05). Clinically, 67% of patients showed an intraoral bone expansion. Approximately 60% of patients with CxOD exhibited a painful symptom, about 3-fold more than those with CpOD (P<0.05), whereas almost all patients with CpOD exhibited perturbations of dentition, unlike those with CxOD (P<0.05). Radiologically, CxOD was characterized by a larger dimension than CpOD in both sexes (P<0.05), and CpOD induced complications in adjacent teeth more often than CxOD (P<0.05). The development of odontoma with advancing age differed significantly in odontoma subtypes related to their pathological origins, and between the sexes, resulting from different physiological states.

CONCLUSION

The findings of this study highlight the value of clinical and radiological features of odontomas and their associated factors for the early diagnosis and adequate treatment of younger patients.

Large erupted complex odontoma mimicking maxillary osteomyelitis

Odontoma is the most common benign odontogenic hamartoma. Odontomas are of two types, such as viz compound and complex odontoma. The complex type is a conglomeration of hard tissues of dental origin. They are primarily intraosseous and usually present in the second decade of life. Most odontomas are asymptomatic, but those erupting in the oral cavity may cause severe infection. They are often associated with impacted teeth and are present with the anterior maxilla showing the highest propensity.The present case report is of a male patient in his early 60s with a substantial solitary sclerotic odontoma of the middle and posterior segments of the maxilla erupted into the oral cavity communicating with the right maxillary sinus. The delayed presentation, size, location and active suppuration can misguide clinicians.

Characteristics, Diagnosis and Treatment of Compound Odontoma Associated with Impacted Teeth

Compound odontoma is a malformation typical of young adults below the age of 20, with a slight preference for the male gender and the anterior region of the maxilla. Clinically asymptomatic, it can be detected during a radiological investigation in connection with the persistence of deciduous dental elements and the impaction of definitive ones. The treatment of choice is excisional surgery and recurrence is a rare event. The need for orthodontic therapy for impacted elements is usually not necessary because in most cases, odontomas are small, circumscribed lesions the size of a permanent tooth. In this article, the diagnostic and therapeutic surgical excision procedure is presented in three patients at developmental age with large compound odontomas associated with at least one retained canine, and in two of the cases, with serious transmigration to the impacted tooth elements.

Surgical resection after orthodontic eruption: A case report of compound odontoma-induced impacted maxillary right central incisor

Herein, we described the multidisciplinary treatment of a mixed dentition patient with impacted maxillary right central incisor and adjacent compound odontoma. In contrast to conventional treatment procedures, orthodontic traction was first performed for the affected tooth in this case, followed by resection of the odontoma. The odontoma did not shift after eruption of the incisor and was safely removed after alignment of the impacted tooth. No root resorption, gingival recession or bone defect occurred in this case. These results demonstrated that the orthodontic force can break the connection between the impacted tooth and the odontoma. The increased distance between the impacted tooth and odontoma may facilitate removal of the odontoma. Adhesion between the soft tissue capsule of odontoma and the dental follicle, rather than blocking the tooth, may play a role in tooth impaction.

Eruption Treatment of Impacted Teeth Following Surgical Obstruction Removal

Supernumerary teeth and odontomas are obstacles for spontaneous tooth eruption and may result in impaction. The aim of the study is to present a conservative treatment approach for impacted teeth following surgical obstruction removal by reviewing three treatment modalities: surgery only, which involves the surgical removal of the obstruction and the spontaneous eruption; surgery with immediate traction, which includes surgery combined with immediate active orthodontic brace cementation and traction; and surgery with delayed traction, which combines a surgical procedure of obstacle removal and orthodontic brace cementation with follow-up for the spontaneous eruption. The first two modalities require orthodontic traction either by an additional surgical procedure for orthodontic brace cementation, or combined with the surgical obstacle removal. With the third approach, clinical follow-up is performed via connected ligature wire elongation applied during the surgical procedure for the spontaneous emergence of the impacted tooth. Active orthodontic traction is only employed if the tooth fails to erupt. The visual follow-up via wire elongation serves as a reference during the emergence of the impacted teeth and reduces the need for radiographic examination. The surgical-orthodontic approach saves both further surgery and orthodontics (spontaneous eruption) or further surgery (in failure to erupt).

ODONTOMAS: PEDIATRIC CASE REPORT AND REVIEW OF THE LITERATURE

Odontomas are benign odontogenic tumors formed from epithelial and mesenchymal cells. They are mostly associated with disorders of tooth eruption, causing impaction and/or delayed tooth eruption, and are an accidental finding on routine radiological examination. The aim of this paper is to present current findings in the etiology and treatment of odontomas, as well as the clinical and radiographic features, describing a case that is rarely found in the literature. A case of multiple complex odontoma in the mandible of an 11-year-old boy is presented, causing impaction of the first permanent right molar, 46. The treatment consisted of surgical enucleation of the multiple complex odontoma with preservation of the impacted tooth, monitoring clinically and radiologically its spontaneous eruption followed by final orthodontic alignment. Odontomas are not an everyday part of clinical practice and given that they are most commonly associated with permanent tooth impaction, it is extremely important to have knowledge of their clinical and radiological features. Early diagnostics and appropriate treatment result in better diagnosis, thus increasing the possibility of preserving the impacted teeth.

Surgical Removal of Odontoma: A Case Report

Odontomas are the most common type of odontogenic tumors. During tooth development stages, any defect in the maturation phase of morphodifferentiation leads to such anomalies. Odontomas are benign, slow-growing, and non-aggressive clinically asymptomatic. This paper describes the case of complex odontoma. A 7-year-old male child reported an asymptomatic hard growth in the right anterior region of the mandible associated with impacted deciduous canine. Radiograph revealed an amorphous mass of calcified material with a radiodensity similar to the tooth structure, with anatomically no resemblance to the tooth, surrounded by a thin radiolucent rim, suggestive of odontoma. Under local anesthesia, access to the lesion was achieved via intraoral approach and surgical excision to enable the eruption of retained permanent canine to establish harmony in the development of dental arch.

How to cite this article: Goswami M, Johar S. Surgical Removal of Odontoma: A Case Report. Int J Clin Pediatr Dent 2020;13(S-1):S122–S124.

Case Report: Interdisciplinary management of a complex odontoma with a periapical involvement of superior anterior teeth

This case report aims to describe the management of a complex odontoma with endodontic involvement of surrounding teeth utilizing a new bioceramic cement consisting of five mineral oxides (5MO) as a retro-filling material. The patient presented for routine consultation with slight dental mobility in the antero-superior region. Upon clinical and computed tomography examination, bone rarefaction was observed in the apical region of teeth 11 and 12, external root resorption in the involved teeth and necrotic pulp of tooth 12. Root canal treatment was performed in teeth 11 and 12. Later, local surgical excision of the lesion was carried out, finding a mass with clinical features of complex odontoma, with histopathological examination of the mass confirming this diagnosis. Retro-filling of tooth 12 with 5MO was carried out. No signs and symptoms were observed over twelve-months of follow-up, with bone neoformation observed in the region. Therefore, 5MO appears to be an effective bioceramic cement that has reparative features.

A Clinical, Radiographic and Histological Study of Unerupted Teeth in Dogs and Cats: 73 Cases (2001-2018)

Lack of dental eruption may be accompanied by development of dentigerous cysts and has also been rarely associated with neoplasia. However, little information is available on prevalence of unerupted teeth and associated lesions in dogs and cats. The main objective of this study was to describe the epidemiologic data of canine and feline dental patients with unerupted teeth, and assess the prevalence of associated dentigerous cysts and tumors. Secondary aims included the evaluation of possible factors implicated in cystic development, and description of the histological features of dentigerous cysts. Medical and dental records, intraoral photographs, intraoral radiographs of client-owned dogs and cats with clinically missing teeth examined between 2001 and March 2018 were reviewed. Collected data included signalment, reason for presentation, number, type, depth of inclusion and angulation of unerupted teeth, presence of cystic lesions or tumors, abnormalities affecting involved teeth, histopathological findings, performed treatment and outcome. Seventy-three animals (69 dogs and 4 cats) with 113 unerupted teeth were included. The most frequent unerupted tooth in dogs was the first premolar teeth (78%), followed by the canine and third molar teeth. Dentigerous cysts were diagnosed associated with 48 (44.4%) teeth in dogs and one out of five unerupted teeth in cats. The affected teeth in dogs were predominantly in horizontal inclination (40%) and in soft tissue inclusion (77%). Brachycephalic canine breeds were overrepresented. The only unerupted tooth in boxer dogs was the first premolar tooth (32 teeth). Ninety percentage of boxers with unerupted teeth developed associated lesions (25 dentigerous cysts and one tumor). Two ameloblastomas (one in a dog and one in a cat) and one osteosarcoma (in a dog) were diagnosed in association with three unerupted teeth. Histology was essential in diagnosing two odontogenic cysts not evident on radiographs. In all cases that were followed-up, treatment (i.e., extraction, extraction and surgical curettage, or operculectomy) appeared successful. Untreated dentigerous cysts showed progression at re-examination. None of the unerupted teeth without evidence of cyst at the time of diagnosis showed incipient cystic development. None of the evaluated factors were associated with lack of eruption and/or development of associated lesions.

Association between odontoma size, age and gender: Multivariate analysis of retrospective data

Background

The variety of characteristics related to odontoma research, including an unexplored one such as size, merits a multivariate approach that allows the adequate drawing of inferences with pertinent conclusions. The objective of this study is to establish the possible association between some characteristics related to the odontoma, tumor size among them.

Material and Methods

The sociodemographic characteristics of 60 patients were evaluated. Diagnosis, size, location, type of treatment performed, and prognosis were determined. These data were analyzed descriptively and through multivariate models.

Results

Thirty-four compound and 26 complex odontomas in 32 men and 28 women were observed. The age average of patients was 15.6±11 years. Most of the odontomas presented a size inferior to 10 mm. A statistically significant association was observed between the routine radiographic finding and the absence of dental eruption (p=0.0001). The model of linear regression adjusted between odontoma size and age (β=0.321, p=0.01), as well as the model of logistic regression adjusted between gender (men) and tumor size (OR=12; 1.7 - 93 IC 95%, (p=0.01) were statistically significant.

Conclusions

Statistically significant associations between odontoma size and age, and between the male gender and odontomas smaller than 10 mm were found adjusting by other confounding variables. These results could grant clinicians a greater knowledge of the context of odontoma characteristics, which in turn could favor a better diagnostic and therapeutic decision-making.

Key words:Odontoma, compound odontoma, diagnosis, multivariate analysis.

Sequential Removal of a Large Odontoma in the Angle of the Mandible

Odontomas are the commonly occurring benign tumors of the jaw, which are odontogenic in origin. Lesion originates as the dental components are laid down in a disorganized manner, due to failure of normal morphodifferentiation. They are considered as hamartomatous developmental malformations rather than a true neoplasm. Mostly, these asymptomatic lesions are discovered as an incidental finding. Large odontomas may give rise to local disturbances, such as eruption delay of permanent teeth, asymmetric tooth eruption, malpositioning, displacement, resorption, or occasional devitalization of adjacent teeth. Odontomas may erupt into the mouth and tend to be associated with impacted teeth and other cystic lesions. The odontomas have a tendency to become symptomatic due to local infection such as sinusitis, infected adjacent tooth, and the exposure of tumor to oral environment. The aim of this paper is to elucidate the primary features and treatment of these lesions, depending on published data and individual witness.

Compound Odontome: A Case Report

Introduction

Odontomas generally appear as small, solitary, or multiple radio-opaque lesions found on routine radiographic examinations. Traditionally, odontomas have been classified as benign odontogenic tumors and are subdivided into complex or compound odontomas morphologically. Frequently, they interfere with the eruption of the teeth.

Case report

This paper describes the case of a compound odontoma in a 10-year-old boy diagnosed after extraction of the retained right primary mandibular first molar in the radiograph. A surgical excision was performed and the histopathological examination revealed a compound odontome.

Conclusion

Early diagnosis of odontomas and complete removal ensures better prognosis.

How to cite this article

Rana V, Srivastava N, et al. Compound Odontome: A Case Report. Int J Clin Pediatr Dent 2019;12(1):64-67.

Giant complex odontoma in the posterior mandible: A case report and literature review

Odontomas are considered a type of odontogenic hamartoma, and are generally reported not to exceed 3 cm in diameter. Some authors have referred to odontomas with a diameter exceeding 3 cm as giant odontomas. As hamartomas, giant odontomas generally show no signs or symptoms, but if they perforate the mucosa to become exposed in the oral cavity, oral and maxillofacial infections can result. Surgical removal and a histopathological examination may also be required to differentiate them from osteomas, cemento-osseous dysplasia, or mixed odontogenic tumors. This report presents the case of a 28-year-old woman with a giant odontoma in the right mandibular third molar area. Based on a review of the literature published since 2010, only 11 cases of “giant” or “large” odontomas have been reported, most of which were of the complex odontoma type. It was confirmed that they tend to occur in the right posterior mandible.

A case of dental hamartoma associated with unerupted primary canine in maxillary region

Odontomas are usually one of the most common odontogenic tumors of the jaw and are perhaps more accurately defined as a hamartoma than a true neoplasm. It is asymptomatic, nonaggressive, slow growing, and benign nature. They are considered to be the malformations of the dental tissue and can sometimes interfere with the eruption of the associated tooth leading to its impaction or delayed eruption. Complex odontomas in primary teeth are rare and unusually diagnosed before the second decade of life. This article aims to present the case of a child with complex odontoma and its effective treatment planning. The results indicate that early diagnosis and proper treatment planning can ensure a better prognosis and can prevent later craniofacial complications and other developmental problems.

Autotransplantation of Odontoma-Associated Impacted Teeth-A Treatment Strategy for Satisfying Immediate Esthetic Demands: A Case Report

Compound odontomas are common odontogenic tumors associated with permanent tooth impaction in the premaxilla. This report describes the case of a 14-year-old girl with an odontoma-associated impaction over the premaxilla that was treated using autotransplantation to satisfy an immediate esthetic demand. At postoperative follow-up conducted in the 14th month, a satisfactory cosmetic appearance with a healthy periodontal status was observed. In addition, the authors discuss the possible complications of autotransplantation and different treatment strategies for odontoma-associated impaction and for correcting bone defects in this case report. Autotransplantation for treating odontoma-associated impaction can be an alternative solution for satisfying an immediate cosmetic demand and providing a favorable outcome.

Clinical, pathological, and genetic evaluations of Chinese patient with otodental syndrome and multiple complex odontoma: Case report

Otodental syndrome is a rare autosomal-dominant disease characterized by globodontia, associated with sensorineural, high-frequency hearing loss. Here, we describe the clinical, pathological, and genetic evaluations of a 9-year-old girl with otodental syndrome and multiple complex odontoma.The patient presented with a draining sinus tract in her left cheek, globodontia, and hearing loss. The odontomas which caused the cutaneous sinus tracts were extracted because of the odontogenic infection. The extracted odontoma and primary tooth was studied by micro-CT and further observed histopathologically. The micro-CT findings revealed that the primary tooth had three crowns with two separated pulp chambers, and their root canals were partially fused. The histological findings showed abnormal morphologies of odontoblasts and dentin, hyperplasia of enamel, and malformation of odontogenic epithelium. Furthermore, DNA sequencing and analyze of deafness associated gene GJB2, GJB3, and PDS had not revealed any SNP or mutation; but exon 3 of the causative gene FGF3 could not be amplified, which may be associated with the microdeletion at chromosome 11q13.3. Three month after surgery, the patient was found to be asymptomatic and even the evidence of the extra-oral sinus had disappeared.The dental abnormality of otodental syndrome included congenital missing teeth, globodontia, and multiple complex odontoma. Globodontia exhibited characteristic features of fusion teeth. In addition, gene FGF3 haploinsufficiency was likely to be the cause of otodental syndrome. The report provides some new information in the field of otodental syndrome, which would make dentists more familiar with this disease.

Clinical parameter of odontoma with special emphasis on treatment of impacted teeth-a retrospective multicentre study and literature review

OBJECTIVES

Odontoma-separated into complex (CxOD) and compound (CpOD) subtypes-represents the most frequent odontogenic malformation. Retention of permanent teeth is a common symptom. Therefore, in a series of odontomas, an analysis of the management of retained teeth was conducted.

MATERIALS AND METHODS

In a retrospective multicenter study of two University Medical Centers and one private praxis in Germany, demographic and clinical data regarding odontomas from 01/2000-03/2015 were obtained. In particular, the influence of operative therapy on the dentition and on the treatment of impacted teeth was analyzed.

RESULTS

Forty-five patients with 15 CxOD and 30 CpOD were included. Initial symptoms were delayed eruption of permanent teeth (n = 11), pain (n = 4), and swellings (n = 2); 28 cases were discovered by incidence, all of them via panoramic radiographs. The mandible/maxilla ratio was about 1:0.55 (29/16). Thirty-five out of 45 odontomas were in close proximity of at least one tooth (n = 16 at molars). A total of 14 teeth were extracted (CxOD: n = 5; CpOD: n = 9). Extractions had to be conducted more often in older patients (mean age 39.8 vs. 25.6 years). Of the non-extracted teeth, 8 teeth were displaced and retained. Of those, 4 teeth were aligned in the dental arch via orthodontic help and 2 teeth erupted spontaneously after operation during the follow-up period. In all cases, no relapse was seen.

CONCLUSION

Odontomas can cause displacement as well as malformation and resorption of the adjacent teeth.

CLINICAL RELEVANCE

Mostly, removal of odontomas is conducted. Extirpation of odontoma can allow for normal tooth eruption, often rendering extractions avoidable. Orthodontic alignment, though sometimes challenging, is a reasonable therapeutic option. These findings underline the value of the panoramic radiograph in preventive dentistry in younger patients.

Erupted complex odontoma delayed eruption of permanent molar

Odontomas, benign tumors that develop in the jaw, rarely erupt into the oral cavity. We report an erupted odontoma which delayed eruption of the first molar. The patient was a 10-year-old Japanese girl who came to our hospital due to delayed eruption of the right maxillary first molar. All the deciduous teeth had been shed. The second premolar on the right side had erupted, but not the first molar. Slight inflammation of the alveolar mucosa around the first molar had exposed a tooth-like, hard tissue. Panoramic radiography revealed a radiopaque mass indicating a lesion approximately 1 cm in diameter. The border of the image was clear, and part of the mass was situated close to the occlusal surface of the first molar. The root of the maxillary right first molar was only half-developed. A clinical diagnosis of odontoma was made. The odontoma was subsequently extracted, allowing the crown of the first molar to erupt almost 5 months later. The dental germ of the permanent tooth had been displaced by the odontoma. However, after the odontoma had been extracted, the permanent tooth was still able to erupt spontaneously, as eruptive force still remained. When the eruption of a tooth is significantly delayed, we believe that it is necessary to examine the area radiographically. If there is any radiographic evidence of a physical obstruction that might delay eruption, that obstruction should be removed before any problems can arise. Regular dental checkups at schools might improve our ability to detect evidence of delayed eruption earlier.

A spatial association between odontomas and the gubernaculum tracts

OBJECTIVES

The purpose of this study was to identify the spatial relationship and/or association between odontomas and the gubernaculum tract or the dental sac and the characteristic findings for radiographic diagnosis of odontomas.

STUDY DESIGN

The visualizations of the odontomas and the gubernaculum tract were retrospectively analyzed using cone beam computed tomography or multidetector computed tomography.

RESULTS

Most of odontomas were within the gubernaculum tract or dental sac of unerupted permanent teeth on computed tomography. In some odontomas, the gubernaculum tract existed as a well-defined low density tract extending from the top of odontomas on computed tomography.

CONCLUSIONS

A close spatial relationship and/or association between odontomas and the gubernaculum tract or dental sac on computed tomography may be used as one of the criteria for radiographic diagnosis of odontomas. Development of odontomas may be associated with the gubernaculum tract or dental sac of unerupted permanent teeth.

Odontomas and supernumerary teeth: is there a common origin?

The aim of the present work is to analyze all scientific evidence to verify whether similarities supporting a unified explanation for odontomas and supernumerary teeth exist. A literature search was first conducted for epidemiologic studies indexed by PubMed, to verify their worldwide incidence. The analysis of the literature data shows some interesting similarities between odontomas and supernumerary teeth concerning their topographic distribution and pathologic manifestations. There is also some indication of common genetic and immuno-histochemical factors. Although from a nosological point of view, odontomas and supernumeraries are classified as distinct entities, they seem to be the expression of the same pathologic process, either malformative or hamartomatous.

Eruption of odontomas into the oral cavity: a report of 2 cases

Odontomas are the commonest odontogenic tumors of the oral cavity and are by nature asymptomatic. They consist mainly of dental tissue that may or may not be arranged in an orderly fashion. Their presence is often detected accidentally or due to the presence of a dental disturbance such as an unerupted tooth. The very rarity of odontomas erupting into the oral cavity validates the need for more current literature on the phenomenon. Our report of two cases aims to present and discuss the rare event of an erupting odontoma with the dental community.

Clinical and surgical management of odontoma

OBJECTIVE AND BACKGROUND

Odontomas are hamartomatous developmental malformations of the dental tissues. We present a retrospective study of recent clinical experience using erbium-doped yttrium aluminum garnet (Er:YAG) (wavelength 2940 nm) and chromium-doped yttrium scandium gallium garnet lasers (Er,Cr:YSSG) (wavelength 2780 nm) for the surgical treatment of these lesions, and score postsurgical pain.

MATERIALS AND METHODS

This retrospective study comprised 35 odontomas treated at the Department of Oral Pathology and Laser-Assisted Surgery, San Martino Hospital, University of Genoa, Italy. Of 35 Caucasian patients (23 male, 12 female; ages 8-35; odontomas localized at various oral subsites) those in Group 1 (n=25) had odontomas excised by laser (Er:YAG laser operating at 2940 nm, pulse width 100 msec, curved handpiece, truncated cone HPX tip, 400 μm with energy output 250-400 mJ per pulse, frequency 15 Hz; and Er, Cr: YSGG laser, power 3.5 W, frequency 20 Hz, 55% air/45% water spray, H (hard tissue) mode, pulse width 190-750 μsec variable). In Group 2 (n=10) odontomas were excised by conventional surgery. Pain was assessed using a visual analog scale (VAS). Clinical outcome was determined at 6-12 months.

RESULTS

Complete responses were achieved in 100% of the laser-treated odontomas, which compares favorably with reported results of conventional surgery. A statistically significant difference in VAS score was found between patients treated with traditional scalpel surgery (median=4.00) and those who underwent laser surgery (median=3.00).

CONCLUSIONS

In treating odontomas, a laser surgery protocol effectively minimizes pain, maintains an excellent clinical outcome, and requires minimal additional treatment time compared with conventional surgery.

A complex odontoma of the anterior maxilla associated with an erupting canine

Many developmental anomalies of the jaw are accidentally diagnosed during radiographic investigations for other symptoms. Complex odontomas are odontogenic tumours, relatively rare in the anterior maxilla and generally asymptomatic. Frequently the odontoma may interfere with the eruption of teeth. This paper describes a case of complex odontoma in an 8-year-old girl, which resulted in the palatal displacement of the lateral incisor and an erupting permanent canine. A calcified mass was seen on the radiograph and was provisionally diagnosed as an odontoma which was surgically enucleated. Routine follow-up was carried out for more than 1 year and no recurrence was seen.

Impeded eruption of mandibular canine

Odontome, tumor of odontogenic origin, is associated with disturbances in the eruption of teeth such as impaction, delayed eruption or retention of permanent teeth. It is seen on radiographic examination as a radiopaque lesion which may be single or multiple. Morphologically, odontomes are of two types-compound or complex and can be found at any age with high prevalence in maxilla than in mandible. In this case report, lack of eruption of permanent mandibular canine owing to presence of associated compound odontome is presented.

The usefulness of cone beam computed tomography for treatment of complex odontoma

BACKGROUND

Odontomas are odontogenic tumours, resulting from epithelial growth and differentiated mesenchymal cells, clinically asymptomatic, and often associated with changes to the eruption of the permanent dentition. In recent years, cone beam computed tomography (CBCT) has been used in the diagnosis and treatment planning of this condition.

CASE REPORT

A 9-year-old male patient, with an unerupted permanent maxillary right central incisor (tooth 11) presented to our clinic. The panoramic radiograph showed impaction of tooth 11 with incomplete root development and the suspicion of an odontome and supernumerary tooth. CBCT was performed and enabled the visualisation of a radiopaque image compatible with an odontome, confirming the presence of an impacted supernumerary tooth on the palatal surface of tooth 11.

TREATMENT

Surgical excision of the odontome and the supernumerary tooth was performed.

FOLLOW-UP

Clinical and radiographic evaluations 2 months after the removal of the lesion showed lack of space for the eruption of tooth 11. The patient was referred for orthodontic treatment and a Hyrax appliance was fitted. The patient has been followed for 12 months.

CONCLUSION

CBCT is an important auxiliary tool, aiding in both correct diagnosis and accurate treatment planning. It is currently a technology accessible to most paediatric dentists and should be beneficial considering the diagnostic information provided as well as the cost-benefit ratio for the patient.

Multiple compound odontomas in mandible: A rarity

Odontomas are benign odontogenic tumors composed of enamel, dentine, and cementum and pulp tissue. They are usually clinically asymptomatic, but often associated with tooth eruption disturbances. The present study reports an unusual case of eleven odontomas in the left lateral incisor-canine region of lower jaw. A 26 years old female presented to the department of orthodontics and dentofacial orthopedics in H.P. Govt. Dental College and Hospital Shimla for the treatment of misaligned teeth. Clinical examination revealed that the lower left lateral incisor was missing. Patient was advised for radiographs, which revealed a mixed radiopaque lesion associated to impacted lower left canine. The histological report in this case indicated a compound odontoma.

Odontomas--silent tormentors of teeth eruption, shedding and occlusion

Odontomas are the most common odontogenic tumours of the jaws, characterised by their slow growth and non-aggressive behaviour. They usually remain asymptomatic, and are diagnosed on routine radiographs. Clinically, they are often associated with delayed eruption or impaction of permanent teeth and retained primary teeth. The purpose of this paper is to review the literature and report two cases of odontomas. In the first case, a compound odontoma was associated with an unerupted maxillary permanent right central incisor, in an 11-year-old boy. In the second case, a 12-year-old girl had retained mandibular primary left central incisor and its unerupted successor was associated with a compound odontoma, a site considered rare for compound odontoma to occur. The clinical features, diagnosis and treatment of these cases have been discussed.

Infected complex odontoma: an unusual presentation

Odontomas represent a hamartomatous malformation. They are usually asymptomatic and are diagnosed on routine radiological examination .The eruption and infection of odontoma are uncommon. Till now, only 20 cases of erupted odontoma are reported in the literature. We report an unusual case of infected complex odontoma with eruption of odontoma in the oral cavity and perforation of the cheeks with a tooth impacted upon which makes the presentation unusual that has not been reported earlier. The dentist should be familiar with common and unusual appearance of odontoma for proper diagnosis and management.

Odontoma-associated tooth impaction: accurate diagnosis with simple methods? Case report and literature review

Odontomas account for the largest fraction of odontogenic tumors and are frequent causes of tooth impaction. A case of a 13-year-old female patient with an odontoma-associated impaction of a mandibular molar is presented with a review of the literature. Preoperative planning involved simple and convenient methods such as clinical examination and panoramic radiography, which led to a diagnosis of complex odontoma and warranted surgical removal. The clinical diagnosis was confirmed histologically. Multidisciplinary consultation may enable the clinician to find the accurate diagnosis and appropriate therapy based on the clinical and radiographic appearance. Modern radiologic methods such as cone-beam computed tomography or computed tomography should be applied only for special cases, to decrease radiation.

Odontoma: a retrospective study of 73 cases

Purpose

The purpose of the present study was to retrospectively evaluate the clinical findings and treatment results for impacted permanent teeth associated with odontomas.

Materials and Methods

We retrospectively investigated 73 odontomas in 72 patients who visited Kyungpook National University Dental Hospital from April 2004 through November 2011. The study was performed using medical records, panoramic radiographs, and pathological reports. Data gathered included age, gender, location, chief complaints, effects on dentition, and treatment of odontoma and the impacted tooth associated with odontoma.

Results

Most compound odontomas (46.7%) were found in the second decade and complex odontomas were not related to age. Odontomas showed no gender predilection. Fifty-five cases (75.3%) of odontomas were detected on routine dental radiographs. Sixty percent of compound odontomas occurred in the canine area and 57.1% of complex odontomas in the molar areas. Impaction of permanent teeth (61.6%) was the most common complication on the adjacent teeth. Most odontomas (84.9%) were removed surgically and impacted permanent teeth were managed by surgical removal (53.2%), orthodontic treatment (25.5%), or surgical repositioning (6.4%). There was a statistically significant relation between age and preservation of the impacted permanent teeth associated with odontomas (p<0.01).

Conclusion

Early detection and treatment of odontomas increase the possibility of preservation of the impacted tooth. Therefore, it would be suggested that periodic panoramic examination during the first and second decade of life might be beneficial for the early detection and better prognosis of odontomas.

Complex and compound odontomas

PURPOSE

This study aimed to analyze and discuss the demographic, clinical, and surgical aspects of 53 surgically treated odontomas and to review the literature.

PATIENTS AND METHODS

A retrospective review was performed on all cases of treated odontomas in our center. A review of the recent literature about demographic aspects of odontomas was performed.

RESULTS

A total of 53 odontomas with a mean age of 35 years were surgically treated during the study period: 32 complex odontomas, 20 compound odontomas, and 1 immature odontoma. Compound odontomas occurred more often at the mandible with a predilection for the anterior region, whereas complex odontomas showed up more often in the posterior regions of the mandible. Odontomas most commonly occurred in patients in the second decade of life. The main presenting sign was the eruption failure of permanent teeth (44 cases), whereas 1 patient referred pain as the presenting symptom.

CONCLUSIONS

Odontomas are hamartomas not rarely encountered by oral and maxillofacial surgeons. Odontomas usually determine delayed eruption; thus, in case of any dentition anomaly or jaw deformation in children and adolescents, it is very important to investigate the presence of possible odontomas with radiographs.

Compound odontoma associated with an unerupted rotated and dilacerated maxillary central incisor

Odontomas are benign tumors containing various component tissues of teeth. They usually remain asymptomatic and are diagnosed on routine radiographs. Clinically, they are often associated with delayed eruption or impaction of permanent teeth and retained primary teeth. A case of compound odontoma in association with an unerupted, rotated and dilacerated maxillary permanent right central incisor in a 12-year-old boy is reported. Such combination is rare, making it an interesting case for reporting. We have also discussed the clinical features, diagnosis and treatment of such a condition.

Clinical and histopathological investigation of odontomas: review of the literature and presentation of 160 cases

PURPOSE

The purpose of the present study was to evaluate the clinical and histopathologic aspects of different types of odontomas.

MATERIALS AND METHODS

One hundred sixty odontoma cases sent to the Institute of Oncology, Department of Tumor Pathology, Istanbul University from 1971 through 2010 were investigated. These tumors were compared by age of patient, gender of patient, localization, histopathologic type, clinical diagnosis, and clinical and microscopic features.

RESULTS

Odontomas were classified histopathologically as complex, compound, or mixed. Of all investigated cases, 99 were complex, 57 were compound, and 4 were mixed odontomas. The mean age at diagnosis was 27.9 years, and odontomas were diagnosed most frequently at 10 to 19 years of age.

CONCLUSIONS

From the perspective of community health, the presence of odontomas within the jaws is important because these constitute 21% to 67% of all odontogenic tumors. The present study showed 2 interesting findings that differed from previous studies. These are the lower incidence rate of odontomas within the category of odontogenic tumors and the higher incidence of complex odontomas over compound odontomas.

A retrospective analysis of the characteristics, treatment and follow-up of 26 odontomas in Greek children

Odontomas represent the most common type of odontogenic jaw tumors among patients younger than 20 years of age. Clinically, they are often associated with eruption failure of adjacent permanent teeth, and are classified as compound and complex. The aim of the present retrospective study was to present the characteristics, treatment approach and outcome of odontomas in Greek children, over a ten-year period. Twenty six patients, 2 to 14 years of age (mean 9.3 years), with odontomas treated during the years 1999-2008 at the Department of Oral & Maxillofacial Surgery of a Children's Hospital, were included in the study. Data from patients' files were retrieved and they were recalled for review. Odontomas were equally distributed in the maxilla and mandible and 42.3% of them were located in the anterior maxilla. Of the odontomas, 80.7% were related to disturbances in tooth eruption. Bone expansion was observed in 65.3% of the cases. All odontomas were surgically removed, and related impacted permanent teeth were either left to erupt spontaneously, orthodontically guided into occlusion or were removed. Orthodontic intervention appeared to be necessary in older children, while in younger children spontaneous eruption was frequent. In the present study, odontomas were associated with unerupted or impacted teeth. Radiographic examination was essential to verify the presence of the tumor and early removal prevented tooth eruption failure and disturbances in a majority of the cases.