Dentigerous cyst associated with multiple complex composite odontomas

Large dentigerous cyst associated with the maxillary impacted supernumerary teeth: A rare occurrence and literature review

Dentigerous cysts are common odontogenic cysts of the jaw but are rarely associated with supernumerary teeth. Few cases of large dentigerous cysts associated with anterior maxillary supernumerary teeth have been reported. The English literature has documented only four cases of dentigerous cysts>40 mm in diameter associated with supernumerary teeth. A 47-year-old man was referred to our hospital, complaining of minor pain in the maxillary gingiva. Computed tomography revealed a well-defined oval unilocular radiolucent lesion (50×45×35 mm) in the right maxilla, including two impacted supernumerary teeth. A dentigerous cyst associated with impacted anterior maxillary supernumerary teeth was diagnosed. The two impacted teeth were surgically removed, and the cyst was enucleated using the Caldwell-Luc approach. Histopathology confirmed the diagnosis of a large dentigerous cyst associated with impacted anterior maxillary supernumerary teeth. The postoperative course has been uneventful for two years. We also reviewed the relevant English literature.

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.

Hybrid odontogenic lesions: A systematic review of 203 cases reported in the literature

BACKGROUND

Hybrid odontogenic lesions combine histopathological characteristics of two or more odontogenic cysts and/or tumours. The aim of this study was to evaluate the available data on hybrid odontogenic lesions (HOL) and to analyse their epidemiological/clinical features and biological behaviour.

METHODS

An electronic search was done in January 2021 using multiple databases. Eligibility criteria encompassed publications with sufficient clinical and histological information to confirm the tumours' diagnoses.

RESULTS

A total of 147 articles were included in this study, comprising 203 cases. Calcifying odontogenic cyst associated with odontoma (COC/OD) (37/18.2%) was the most common HOL. Females were more affected with a mean age of 24.9 years. Lesions presented as asymptomatic swellings, with a mean evolution time of 8.2 months (0.3-96), and mean tumour size of 4.8 cm (0.3-7). Radiographic aspects frequently showed radiolucent (139/68.4%) and unilocular (52/25.6%) images with well-defined limits (48/23.6%). The lesions mostly affected mandibular pre-molars (69/34%) and mandibular molars (69/34%) regions. Enucleation (89/43.8%) and surgical excision (59/29%) were the most common treatment modalities. The mean follow-up time was 33.8 months (0.5-216 months) and recurrences were observed in four cases (1.9%), all of which were central odontogenic fibroma associated with central giant cell granuloma (COF/CGCG).

CONCLUSION

COC/OD is the most common HOL and recurrence is a rare event, being usually associated with the diagnosis of COF/CGCG.

Odontome, Cyst, Impacted Tooth, and Space Infection in a Single Patient: All-in-One Diagnostic Dilemma

This case report analyzes the clinical and radiographic features of odontogenic infection with underlying pathology. Systematic approach leads to narrow the differential diagnosis on the basis of exclusion. This results in correct diagnosis, proper treatment, and avoiding unnecessary treatment. This case report highlighted an unusual case of odontogenic infection involving adjacent fascial spaces with underlying pathology which was mimicking a cyst, tumor, and odontome. Systematic approach helped us achieve accurate diagnosis, treatment, and avoiding complications.

Cystic Odontoma in a Patient with Hodgkin's Lymphoma

Cystic odontoma is a rare entity, which is characterized by the association of a cyst with complex/compound odontoma. The aim of this study was to report the case of a 5-year-old male patient diagnosed previously with Hodgkin's lymphoma and treated successfully with chemotherapy and radiotherapy, who developed a mandibular odontogenic lesion. Physical examination revealed a swelling on the right side of the mandible. Radiographically, a well-defined radiolucent area surrounded by radiopaque material was observed. An incisional biopsy was performed and microscopic analysis showed a cystic lesion consisting of an atrophic epithelium comprising 2-3 cell layers and the absence of inflammation in the cystic capsule. The cyst was decompressed and the lesion was removed after 3 months of follow-up. Microscopic analysis of the surgical specimen showed a cystic hyperplastic epithelium surrounded by an intense chronic inflammatory cell infiltrate, which was in close contact with mineralized tissue resembling dentin and cementum. The final diagnosis was cystic odontoma. Since chemotherapy can affect the growth and development of infant teeth, a relationship between chemotherapy-associated adverse events and cystic odontoma is suggested in the present case.

Bilateral coronoid hypoplasia and complex odontoma: a rare concurrence of developmental pathology and odontogenic tumour of the mandible

We present a rare case of concurrent bilateral coronoid hypoplasia and complex odontoma in the mandible, with replacement of missing posterior teeth in both sides of the lower jaw. A 20-year-old woman was diagnosed with bilateral occurrence of coronoid hypoplasia and unerupted complex odontoma after radiographic and histopathological examination. The patient was surgically treated with complete removal of the unerupted complex odontoma and prosthetic replacement of the missing teeth.

Orthokeratinizing odontogenic cyst of maxilla with complex odontoma

The orthokeratinized odontogenic cyst (OOC) and odontoma are the odontogenic cyst and tumor respectively that are minimally invasive neoplasms of head and neck region. OOC is a rare variant of odontogenic cyst characterized by the presence of excessive orthokeratin covering the cystic lining. Odontoma is a benign neoplasm/hamartoma often discovered accidently on panoramic radiographs. We came across a case of a 26-year-old male with swelling on his face along with difficulty in breathing. On the basis of radiographic and histopathological findings the final diagnosis of OOC associated with odontoma was given. However, there is no report in the English literature of the simultaneous occurrence of these two lesions and hence this case is very rare. It is unclear whether the two lesions were just coincidental or were actually related to each other.

Histopathological insight of complex odontoma associated with a dentigerous cyst

Odontomas and dentigerous cysts are common findings for practicing dental professionals. However, simultaneous occurrence of pathologies like odontoma and dentigerous cyst are uncommon and their diagnosis based on the radiographic appearance alone is a challenge to overcome. They together are a potential for complications like attaining large size, root resorption, destruction of the jaw bones and sometimes neoplastic changes like ameloblastoma. This paper presents a case of complex odontoma associated with dentigerous cyst in relation to a retained deciduous tooth in the maxillary anterior region and confirming its diagnosis histopathologically.

Histopathological insight of complex odontoma associated with a dentigerous cyst

Odontomas and dentigerous cysts are common findings for practicing dental professionals. However, simultaneous occurrence of pathologies like odontoma and dentigerous cyst are uncommon and their diagnosis based on the radiographic appearance alone is a challenge to overcome. They together are a potential for complications like attaining large size, root resorption, destruction of the jaw bones and sometimes neoplastic changes like ameloblastoma. This paper presents a case of complex odontoma associated with dentigerous cyst in relation to a retained deciduous tooth in the maxillary anterior region and confirming its diagnosis histopathologically.

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.

Surgical management of an erupted complex odontoma occupying maxillary sinus

The occurrence of complex odontomas is not considered to be rare in the jaws. But the occurence of large odontomas obscuring the maxillary sinus, or erupting into the oral cavity are considered to be rare. The prognosis is good with surgical excision and recurrence is nil. Most of the times the surgical site can be closed primarily, but sometimes requires local flaps to achieve tension free closure. Here, we report such a case treated by surgical excision trans orally followed soft tissue defect reconstruction with pedicled palatal island flap.