A novel APC mutation associated with Gardner syndrome in a Chinese family

Gardner syndrome (GS) is a specific form of familial adenomatous polyposis (FAP), which manifests as colorectal polyps, multiple osteomas and soft tissue tumors, and in the oral cavity as osteomas of the jaws, odontomas, and abnormal tooth counts. The underlying cause of GS is attributed to mutations in the APC gene. Mutations in this gene disrupt the normal functioning of the protein and lead to the development of GS. To further investigate GS, a family affected by the syndrome was selected from Dongguan, Guangdong Province. The family members underwent a comprehensive survey, which involved collecting clinical data and peripheral venous blood samples. The samples were then used for genetic analysis. Whole exome sequencing (WES) and Sanger sequencing techniques were utilized to screen and identify specific mutation sites in the APC gene. The clinical findings for the GS family included the presence of gastrointestinal polyps and odontomas. After analyzing the genetic sequencing results, a novel mutation site c.4266dupA on the APC gene was found in the patients, which leading to the APC protein truncation. As a result of this study, it is suggested that odontoma may be an early indicator of GS. Additionally, the identification of this novel mutation site in the APC gene expands the known spectrum of genetic mutations associated with the disease. This discovery has significant implications for the early diagnosis of GS, thus enabling timely intervention to reduce the risk of developing colon cancer and other related diseases.

Dentinogenic ghost cell tumor associated with odontoma: report of a rare case and review of literature

Dentinogenic ghost cell tumor (DGCT) is an uncommon odontogenic tumor considered to be the solid, tumorous variant of calcifying odontogenic cyst. DGCT is characterized by islands of ameloblastoma-like epithelial cells that resemble the enamel organ, the presence of ghost cells, and dentinoid material. This article reports a rare case of dentinogenic ghost cell tumor associated with an odontoma in an adult patient, with a review of the literature. To the best of the authors' knowledge, there have only been four case reports of DGCT associated with odontoma, all of which occurred in children and adults younger than 30 years old.

Timing and treatment sequence in the management of odontomas associated with impacted teeth: A literature review and report of two cases

AIM

This study aims to highlight the importance of early diagnosis, timing, optimal treatment sequence and multidisciplinary approach as key factors in the orthodontic management of impacted and retained teeth associated with odontomas.

METHODS

Literature about classification, epidemiology, aetiopathogenesis, histopathology and therapeutic options about odontomas and impacted teeth in orthodontics was reviewed. Two case reports are presented, showing different timing in diagnosis and surgical removal of odontomas and some biomechanical approaches.

CONCLUSION

An early removal of the odontoma is certainly a more effective and simpler procedure in the approach to this problem.

Compound odontoma associated with a calcifying odontogenic cyst. Case report and systematic review

The objectives of the present study were to comprehensively evaluate all the published cases on compound odontoma associated with calcifying odontogenic cyst (COaCOC) in the English literature and to describe the clinical, imaging and therapeutic variables for this condition. In August 2020, an electronic search of the PubMed / MEDLINE, Web of Science, ScienceDirect, Springer, and Scopus databases was carried out. The eligibility criteria included publications with enough information to confirm the diagnosis. Furthermore, we present a clinical case of a 16-year-old male patient with OCCaC, who was treated with enucleation, obtaining favorable and functional results. A total of 32 cases reported in the literature that met the inclusion and exclusion criteria, including ours, were analyzed and discussed. The mayority of the patients were women (n = 17) with an average age of 14.4 years, the maxilla was the most affected bone (n = 22) and the maxillary anterior region was the area with the highest number of cases (n = 18), the main clinical presentations were the volume increase (n = 14) and asymptomatic (n = 14). The choice treatment was enucleation (n = 26) and, in most cases, no recurrence was reported (n = 20). This study allows to update the characteristics of the OCCaC, giving an effective vision of how to treat this rare pathological association made up of two conditions that are completely different from each other.

Delayed Eruption of Permanent Lower Lateral Incisor in Relation to Compound Odontoma: A Case Report

AIM

To report a delayed tooth eruption following late surgical removal of a compound odontoma in a 10-year-old child.

BACKGROUND

Odontomas are the most common odontogenic tumors. They are usually asymptomatic and discovered during routine radiographic examinations or during an assessment of delayed tooth eruption. Odontomas are classified into compound or complex based on the microscopic structure of dental tissues. Early diagnosis and surgical removal of odontomas is the keyword for favorable results.

CASE DESCRIPTION

This paper describes a case of compound odontomas in a 10-year-old boy that prevented eruption of the permanent mandibular lateral incisor. Extraction of mandibular primary lateral incisors and surgical excision of the compound odontomas was performed. After 3 years of follow-up, at the age of 13 years, the permanent lateral incisor erupted and approached the occlusal plane.

CONCLUSION

Late surgical removal of odontomas resulted in a delayed eruption of the affected teeth.

CLINICAL SIGNIFICANCE

Surgical removal of odontomas and regular follow-up to monitor the eruption of the affected teeth should be considered for the teeth with an open apex before considering orthodontic traction.

A Bag of Marbles: A Fascinating Compound Odontoma of the Maxilla

Odontomas are the most common odontogenic tumors, typically diagnosed during the first two decades of life. 1 The purpose of this paper was to report an interesting case of an eight-year-old Caucasian boy who presented with an asymptomatic, progressive, firm swelling of the right maxilla with no eruption of the permanent maxillary right lateral incisor. Radiographic investigation revealed a mixed radiolucent and radiopaque lesion measuring 28 by 24 by 17 mm with a corticated border causing expansion and thinning of the buccal cortical plate. This large bag-of-marbles-like appearance representing odontoids was impeding his adult teeth from erupting; hence, complete surgical removal under general anesthesia was the treatment of choice. Removal of the lesion resulted in an unexpected loss of the embedded permanent maxillary right lateral incisor. Histopathological investigations gave a diagnosis of compound odontoma; due to their low growth potential, recurrence after removal is not expected.

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.

Midline diastema and its aetiology--a review

Maxillary midline diastema is a common aesthetic complaint of patients. Treating the midline diastema is a matter of concern for practitioners, as many different aetiologies are reported to be associated with it. The appearance of midline diastema as part of the normal dental development makes it difficult for practitioners to decide whether to intervene or not at an early stage. The aim of this article is to review the possible aetiology and management options which will help the clinician to diagnose, intercept and to take effective action to correct the midline diastema. The available data shows that an early intervention is desirable in cases with large diastemas. Treatment modality, timing and retention protocol depends on the aetiology of the diastema. Therefore, priority needs to be given to diagnosing the aetiology before making any treatment decisions. Clinical Relevance: This article aims to determine and evaluate the aetiology and possible treatment options of midline diastema.

Erupted composite odontoma associated with malformed teeth - unusual dental aberrations following maxillofacial trauma

BACKGROUND

Tooth development may be hampered following traumatic injuries to maxilla or mandible. The developmental deviations that occur in a tooth bud in the line of a jaw fracture range from agenesis to hamartomatous proliferation. Odontomas are benign odontogenic hard tissue tumors, which are hamartomas characterized by slow growth and non-aggressive behavior. 'Erupted odontoma' is a term used to specifically denote odontomas, which are exposed into the oral cavity. These are rare entities with only 25-30 cases being reported so far in the dental literature.

CASE DESCRIPTION

This clinical report is pertaining to a rare case of an erupted odontoma in an adolescent patient which was presenting as a hard tissue outgrowth along with an extra-oral sinus in the posterior mandibular region. The surgical excision of the odontoma along with the associated malformed teeth resulted in resolution of pain and sinus discharge associated with this lesion.

CONCLUSIONS

Erupted odontomas need to be considered in the differential diagnosis of hard tissue projections or outgrowths in the site of past maxillofacial injuries. Surgical excision of these lesions enable resolution of patient symptoms associated with this condition as evidenced in the present case and in other cases cited in the literature. The erupted odontoma attached to malformed molars and presenting with signs and symptoms suggestive of osteomyelitis is a rare combination of developmental aberrations following maxillofacial injury.

Treatment protocol for the impaction of deciduous maxillary anterior teeth due to compound odontoma

The purpose of this paper was to describe the dental and surgical management of the impaction of deciduous maxillary anterior teeth due to compound odontoma. In all analysed patients impaction of the maxillary deciduous canine was associated with the presence of an odontoma. Therefore, impaction of the maxillary deciduous canine can be considered as pathognomonic of the presence of an intraosseous odontoma. The analysis of the described cases showed that early diagnosis and early removal of the odontoma are essential in improving the prognosis of the involved teeth. Early treatment allows the impacted tooth to re-start the physiological eruption. A conservative surgical approach is advisable in order to minimise damage to the impacted teeth and preserve their normal timing and path of eruption.

Management of compound odontoma in a 10-year-old girl preserving the associated impacted permanent tooth

AIM

Compound odontoma has been reported to be the most common of all odontogenic neoplasms and tumor- like lesions. Only rarely the treatment of this lesion in association with an impacted tooth has been reported.

CASE REPORT

A compound odontoma in a 10-year-old girl, associated with an impacted permanent incisor is described, focusing on the diagnosis and the importance of early treatment of this lesion. The patient underwent surgical excision of the lesion and it was decided to wait for the spontaneous eruption of the impacted tooth. After 6 months no eruption was observed and thus the orthodontic treatment was deemed necessary. At the one-year follow-up, the tooth was brought into the maxillary arch.

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.

[Prevention of the eruption of an upper later incisor by a compound odontoma. Case report]

Odontomas are the most common odontogenic tumours. They are considered as hamartomas - a local tissue malformation without autonomous growth potential - and are non-neoplastic. Clinically and histopathologically, compound and complex odontomas can be differentiated. Compound odontomas consist of a varying number of tooth-like structures and histology show dental tissues in an orderly pattern. Most often compound odontomas are diagnosed in young patients in the anterior maxilla. Patients are rarely complaining of symptoms and they are usually diagnosed during routine radiographic examinations or due to late eruption of permanent or persistence of deciduous teeth. The following case report presents a disturbed eruption of a lateral right incisor of the maxilla in a 8-year old female patient. Clinical, radiological and histopathological characteristics of this lesion will be discussed as well as therapy and follow-up.

Complex odontoma: report of a five-year follow-up case

Odontomas are odontogenic tumors that usually present as benign lesions. They are easily diagnosed and affect individuals in their first and second decades of life. In most cases, odontomas are asymptomatic and the presence could be suspected due to the delay in tooth eruption or via routine radiographic examinations. Treatment of choice has been surgical removal of the lesion, and prognosis is usually favorable because of its benign characteristics and rare recurrence. The purpose of this study is to report the case of a complex odontoma in a child impacting a permanent molar and preventing its eruption. The lesion was surgically removed, and the eruption of the permanent mandibular left second molar tooth occurred after 5 months. Clinical, radiographic, and histopathological characteristics were studied in this case.

Large erupting complex odontoma in a dentigerous cyst removed by a piecemeal resection

Odontomas (ODs) are the most frequent odontogenic tumors in Western societies, they are often asymptomatic and discovered during routine radiography The purpose of this report was to describe the case of a 10-year-old child with an odontoma within a dentigerous cyst (DC). The patient presented with a 1-week history of painful swelling involving the right mandible and cheek. An intraoral examination revealed a defect of the oral mucosa behind the permanent mandibular first molar, which resembled an exposed alveolar bone or tooth remnants. Clinical and radiographic evaluation revealed a large erupting OD associated with a dentigerous cyst. The OD was separated into pieces and enucleated together with the dentigerous cyst to preserve the mandible's integrity and because of the patient's age. This is the first report of an erupting OD associated with a DC in a child. Surgical removal might be a challenge when large ODs are encountered.

Simultaneous occurrence of compound odontoma and arrested root formation as developmental disturbances after maxillofacial trauma: a case report

Traumatic injury to a primary tooth and/or a bone fracture has the potential to damage the underlying permanent tooth germ which may disturb its development. The extent of the malformation depends on the developmental stage of the permanent tooth and the intensity of the trauma. The presence of infection may be a predictive factor for these abnormalities. Open surgical procedures can also potentially cause impaction and developmental disturbances. Several developmental alterations such as discolouration, hypoplasia, crown dilaceration, root angulation or dilaceration, sequestration of permanent tooth buds and disturbance in eruption have been reported in permanent teeth after trauma. However, odontoma-like malformations and partial or complete arrest of root formation are rare complications developed after trauma. This article presents a rare case with simultaneous occurrence of an odontoma-like malformation and complete and partial arrested root formations as the results of maxillofacial trauma. Almost all pediatric fractures must be managed with closed reduction as much as possible. However, if it is necessary to perform an open reduction, careful attention must be paid during placement of the osteosynthetic plates and screws; and tooth bud development must be followed periodically.

Odontomas: a clinicopathologic study in a Portuguese population

OBJECTIVE

Odontoma is a tumorlike malformation (hamartoma) that contains odontogenic epithelium with odontogenicectomesenchyme. Frequency and distribution of odontogenic tumor among a Portuguese population were analyzed and compared with previous reports.

METHOD AND MATERIALS

A total of 65 odontogenic tumor cases were collected from the files of the Department of Pathology of Hospital Sao Joao,Porto,Portugal, and the Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), from January 1993 to December 2006. Of these cases, 48 were retrieved and analyzed. The final diagnosis of each case was based on the 2005 WHO histopathologic classification of odontogenictumors, and to the authors' best knowledge, the present series represents the first study on odontomas in a northern Portuguese population.

RESULTS

Of the 65 odontogenic tumors cases, 64 (98.5%) were benign and 1 (1.5%), an ameloblasticcarcinoma, was malignant. Odontoma was the most frequent odontogenic tumor (73.9%), followed by unicysticameloblastoma(7.7%) and calcifying cystic odontogenic tumor (7.7%). Of the 48 odontomas(26 males and 22 females), 34 (70.8%) were compound and 14 (29.2%) were complex. Most odontomas(72.9%) occurred in patients under the age of 30, with a peak incidence in the second decade of life. Twenty-eight (58.3%)odontomas were in the maxilla and 20 (41.7%) in the mandible (P<.05). Twenty-eight (58.3%) of the 48 odontomas were associated with 33 impacted teeth, including 31 permanent teeth, 1 primary tooth, and 1 supernumerary tooth. The maxillary central incisor (n= 6; 19.4%) and the maxillary canine (n= 6; 19.4%) were most commonly associated with odontoma, followed by the mandibular canine (n= 5; 16.0%) and maxillary third molar (n= 4; 12.9%).

CONCLUSION

This study provides clinical and pathological information on odotogenic tumors in a nothern Portuguese population

Central incisor impacted by an odontoma

AIM

The aim of this report is to present a clinical case of impaction of a maxillary left central incisor in a mixed dentition caused by the presence of an odontoma as well as a review of the pertinent dental literature.

BACKGROUND

Knowledge of the normal tooth eruption patterns is essential for the identification and appropriate treatment of deviations in eruption that may endanger physiologic development. A delay in time between the exfoliation of a deciduous tooth and the eruption of its permanent successor may be related to a disorder known as dental retention. This occurs when tooth eruption does not occur within a normal time frame, the tooth is not present in the dental arch, and there is no potential for eruption due to the presence of a completely formed root or when the homologous tooth has been erupted for at least six months with complete root formation.

REPORT

A 10-year-old boy in the mixed dentition stage presented with an impacted maxillary left central incisor due to the presence of an odontoma. Treatment included the surgical removal of the lesion and the follow up of the spontaneous eruption while a partial fixed appliance was used to recover the space of the missing tooth. Since spontaneous eruption failed to occur within the expected time frame, surgical exposition of the crown and bonding of an orthodontic appliance for traction was done to facilitate eruption.

SUMMARY

The incisor was integrated to the dental arch without any root or periodontal sequelae. The treatment was considered a success, since both health and aesthetics of the smile were recovered. The importance of the clinical and radiographic diagnosis of the retention of a permanent tooth associated with a pathological entity should be emphasized. The participation of a multidisciplinary team to accomplish the appropriate treatment of such patients is extremely relevant because of the esthetic and functional ramifications of a missing anterior tooth as well as the psychological well-being of the individual.

[Compound odontoma as a cause of chronic maxillary sinusitis]

Sinusitis of dental origin is a relatively frequent entity, but the presence of an odontoma in the sinus as a source of this pathology is exceptional. Here we present a case of a young patient who presented chronic maxillary sinusitis over 2 years, originating in an odontoma located in the sinus drainage area.

Submandibular cellulitis (Ludwig's angina) associated to a complex odontoma erupted into the oral cavity. Case report and literature review

The clinical presentation of Ludwig's angina consists in a severe expanding cellulitis causing swelling of the floor of the mouth, tongue and submandibular region, thus resulting in a possible obstruction of the airway and in a rapid progress in deep neck soft tissue infection and mediastinitis with potentially fatal consequences. Frequently, submandibular cellulitis develops from an acute infection spreading from the lower molar teeth. Mandibular fractures, traumatic laceration of the floor of the mouth, and peritonsillar abscesses are other concomitant clinical features. A case of Ludwig's angina associated with a large erupted odontoma and with a deeply impacted third molar displaced to the border of the mandible is described. The patient was affected by enlargement of submandibular space, marked face swelling causing an evident face deformity, tenderness and redness of the neck and limited movement of the neck and mouth. In the past, Ludwig's angina was frequently fatal, however aggressive surgical and medical therapy have significantly reduced the mortality rate. The reported case can be considered as important, not only because of the rarity of the odontoma eruption in the oral cavity, but mainly for the extent of the clinical manifestation of a lesion usually described in literature as asymptomatic.

[Combined surgical-orthodontic therapy for compound odontoma]

Odontogenic tumor is a rare condition in dental medicine that mostly proceeds unrecognized until the occurrence of clinical symptoms such as delayed eruption, or is incidentally detected on routine x-ray examination. The exact cause is not known, however, previous dental trauma and infection have been postulated as the potential factors in the development of odontogenic tumor. The earliest possible operative extirpation of the tumorous growth is recommended to eliminate permanent tooth impaction and to enable normal growth of the teeth. In some cases, corticotomy, including complete removal of the bony coat of the tooth, may be needed to additionally facilitate and precipitate its eruption. Orthodontic therapy is also of great importance in correct alignment of the teeth 'n the dental arch as well as in the management of other anomalies that may be associated with odontogenic tumor. A patient with compound odontoma is presented, along with the course of combined surgical-orthodontic therapy. The patient reported previous intrusion trauma that had occurred at the age of 4 years, which may have been the potential factor in the development of odontoma. In this case, there was a massive odontogenic tumor which had compromised the growth of permanent teeth, and the growth impulse was almost at the end since the patient was 11 years old and the apexes of the upper incisors were partially closed. The first operation included complete removal of the tumorous mass that had interrupted spontaneous eruption of the upper permanent incisors. It did not result in immediate spontaneous tooth eruption, so an additional operation was needed. The objective of the second operative procedure was complete removal of the covering bone over the unerupted upper permanent incisors in order to eliminate the physical barrier to tooth growth and eruption. The objective of fixed orthodontic therapy was full eruption of the partially erupted upper incisors. After 16 months, the upper incisors were regularly located in the dental arch. In this case, orthodontic therapy had another objective, i.e. to ensure rotation of the first upper premolar, to provide space for the upper permanent canine eruption and to establish regular intercuspidation after upper second premolar hypodontia. In colclusion, combined operative and orthodontic therapy can be recommended irrespective of the stage of the impacted tooth development because any treatment to precipitate tooth eruption has favorable effects. Impacted teeth should always be provided all treatment options for faster eruption, as demonstrated in our case where a good clinical result was achieved within 2.5 years. The role of regular clinical and x-ray controls for assessment of the impacted tooth eruption should also be emphasized.

[Ameloblastic fibro-odontoma of the maxillary sinus]

INTRODUCTION

Ameloblastic fibro-odontoma, ameloblastic fibroma, and odontoma are rare malformations, which are classified as odontologic tumors. They usually progress in an asymptomatic way, and making the histological distinction between these variants is very difficult.

OBSERVATION

We report the case of a 14-year-old girl presenting with an ameloblastic fibro-odontoma of the maxillary sinus. The clinical signs were nasal obstruction and jugular tumefaction. Surgical excision was performed through a paralateronasal approach. The diagnosis of fibro-odontoma was confirmed by the histopathological analysis of the surgical piece.

DISCUSSION

Odontologic tumors form a complex entity, the histological nature and the correlations of which are discussed.

Complex composite odontoma associated with impacted tooth: A case report

Odontomas are the most common type of odontogenic tumors and are generally asymptomatic. This paper describes the case of a complex composite odontoma in a patient who had an asymptomatic swelling in the maxillary molar region, along with the impacted third molar. In this case, surgical excision of the lesion was performed, and the impacted third molar was intentionally left in situ so that it could erupt to the level of occlusion.

The use of multidirectional cross-sectional tomography for localizing an odontome

BACKGROUND

A 7-year old boy was referred with retained maxillary right primary central and lateral incisors. Radiographic exam revealed a large calcified radio-opaque mass overlying the roots of these primary teeth preventing the permanent teeth from erupting.

CASE REPORT

The purpose of this paper is to describe the pre-operative use of multi-directional cross-sectional tomography in establishing the relationship between a large complex odontome that was preventing the eruption of a maxillary permanent central incisor.

CONCLUSION

Low dose, multi-directional cross-sectional tomography was beneficial in visualisation of the precise relationship between the large complex odontome and the unerupted permanent incisor. This allowed correct judgement of the position on the odontome prior to its surgical removal.

Compound odontoma causing airway obstruction of the newborn: a case report

A newborn presented with acute airway obstruction secondary to a compound odontoma of the hard palate/nasal floor. This is the first case recorded in the literature. We review the pathology of compound odontomas and discuss the management of this rare and interesting case.

Odontomas in pediatric dentistry: report of two cases

Odontomas are developmental disturbances which manifest in the form of denticles or amorphous informes masses comprising all dental tissues, especially enamel and dentin, with variable amounts of pulp and cement. We describe here two clinical cases of odontomas in children, focusing on diagnostic means and the importance of early treatment of these lesions. The standard treatment for the two present cases was surgical removal.

Delayed eruption of a mandibular primary cuspid associated with compound odontoma

Although odontomas are considered to be a common type of odontogenic tumor, they rarely occur solely in the primary dentition. This case report presents an eight and a half-year-old-child with a compound odontoma located in the mandible, which caused the impaction of both primary and permanent canines.

Calcifying odontogenic cyst associated with complex odontoma: case report and review of the literature

We report a calcifying odontogenic cyst associated with odontoma (COCaO) and an included permanent canine in the superior maxilla, in a 19 year-old-man. The calcifying odontogenic cyst (COC) was first described as a distinct entity by Gorlin et al in 1962. The lesion is a mixed odontogenic benign tumor, and although most of the cases present cystic characteristics, a few are of the solid type (15%), and its rare malignant transformation is well documented. The COC may occur in association with other odontogenic tumors, the most common is the odontoma, occurring in about 24% of the cases. For this association the term Odontocalcifying odontogenic cyst has been suggested. Radiographically is a well defined mixed lesion and histologically consists of a large cyst. In the central area of the cyst enamel and dentin deposits can be found, irregularly distributed in areas and in other parts it takes on a well defined organoid aspect. A thorough review of literature takes place and the pathogenesis is discussed.

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

Retrospective investigations of odontomas in Japanese children and one recurrent case were carried out. Thirty-nine cases of odontoma in 38 children were treated in the Paediatric Dentistry Clinic of Niigata University Dental Hospital between September 1979 and December 2002. The patients consisted of 23 males and 15 females and their ages ranged from 1 year 2 months to 14 years old. The chief complaints were delayed tooth eruption in 19 cases (five: primary teeth, 14: permanent teeth), retention of primary teeth in 11, incidentally found on the radiographic examination in eight cases, and swelling of the jaw in one case. Thirty-four cases (87%) were associated with tooth eruption disturbances. The most frequently affected region was the maxillary anterior region. Treatment consisted of surgical removal of odontomas in all cases, after which if the impacted teeth did not erupt, exposure of the crown and/or orthodontic traction was performed. Pathological diagnoses were compound odontoma in 30 cases, complex odontoma (n = 7), and compound and complex odontoma (n = 2). A retrospective study of the radiographs revealed the developing process of odontomas in four cases and odontoma disturbed tooth eruption since the early uncalcified developing stage. A recurrent case was a boy aged 6 years 5 months in whom the first surgical removal of odontoma was performed at the age of 1 year 8 months. Recurrence of an odontoma is very rare, but in very young children odontomas are in the early developing stages, containing uncalcified portions, so it is important to perform periodical observations until the succedaneous teeth erupt.

Interceptive management of eruption disturbances: case report

The aim of the present report is to describe a case of a patient with eruption disturbances of an ankylosed lower primary second molar, delayed development of a maxillary permanent canine associated with an odontoma and a class III dental malocclusion. In such a case the objectives of treatment are: to prevent impaction of the lower second premolar and tipping of the lower first molar; to establish correct anterior overbite and overjet and to control the development of the permanent upper canine.

Orthodontic treatment of impacted anterior teeth due to odontomas: a report of two cases

Two cases are presented where the odontomas had caused the impaction of the anterior teeth and required a combined surgical and orthodontic treatment to bring these teeth into the arch. In the first case a large a complex odontome had caused the impaction of the right central incisor, lateral incisor and canine. In the second case a compound odontome blocked the eruption pathway of the right central incisor. It is emphasised that radiographic examination of all pediatric patients that present clinical evidence of delayed permanent tooth eruption or temporary tooth displacement with or without a history of previous dental trauma should be performed. Early diagnosis of odontomas allows adoption of a less complex and less expensive treatment and ensures a better prognosis.

Odontoma of the middle ear: case report with 25-year follow-up

We report the 25-year follow-up on the first reported case of odontoma in the middle ear. Diagnosis of odontoma had been made on the basis of radiography films that showed a middle ear mass with multiple toothlike areas of radiopacity. No clinical intervention was recommended. At 25-year follow-up, audiometry showed progressive mixed hearing loss on the affected side and mild ipsilateral sensorineural hearing loss. Computed tomography better characterized the discrete mass, which was shaped similar to a dental crown. To avoid jeopardizing cochlear and facial nerve function, no surgical intervention was pursued, and we recommended use of a BiCROS (bilateral contralateral routing of signal) hearing aid.

A compound composite odontoma associated with unerupted permanent incisor--a case report

Odontomas are the most common type of odontogenic tumors and generally they are asymptomatic. Frequently it may interfere with the eruption of the teeth. This is a case report of a compound composite odontoma in a 9 year old girl, which results in failure of eruption of the permanent upper right central incisor while the contralateral tooth had erupted. A calcified mass was seen in the radiograph and was provisionally diagnosed as odontoma following which the odontoma was enucleated. Routine follow up was done for more than a year and no recurrence was seen. This case report indicates that early diagnosis and management ensures better prognosis.

Odontoma: a clinicopathologic study of 81 cases

BACKGROUND AND PURPOSE

Odontoma is the most common odontogenic tumor. It includes 2 types, the compound and complex odontomas. There has not been a series study of the clinical and histologic features of odontomas from Taiwan. This study evaluated the clinicopathologic features of odontoma in Taiwanese.

METHODS

Cases of odontoma treated from 1998 to 2002 identified from medical records were included. The microscopic features, radiographic features, and clinical history of the patients were reviewed and analyzed.

RESULTS

A total of 81 odontomas in 81 patients (36 males and 45 females) were included. There were 62 compound and 19 complex odontomas. The mean age of the patients was 18 years with the majority of odontomas occurring in the first (32%) and second decade (38%) of life. Odontomas had a marked predilection for the maxilla (70%) and for the anterior region of the jaw (83%), particularly for the anterior maxilla (62%). Sixty four (79%) of the 81 odontomas were associated with 80 impacted teeth, including 71 permanent teeth, 2 deciduous teeth, and 7 supernumerary teeth. Of the 71 impacted permanent teeth, the maxillary central incisor (27%) was most commonly affected, followed by the maxillary canine (26%) and mandibular canine (24%). Histologic examination revealed enamel matrix in 90%, dentin in 100%, cementum in 88%, pulp tissue in 96%, fibrous capsule in 93%, ghost cells in 83%, reduced enamel epithelium in 86%, and nests of odontogenic epithelium in 58% of odontomas. Dentigerous cyst was associated with 9% of odontomas.

CONCLUSIONS

In this series, odontomas occurred most often in the first and second decade of life. Although complex odontomas are usually found in the posterior jaw, in this Taiwanese series they were most commonly found in the anterior maxilla. Odontoma is frequently associated with an impacted tooth and occasionally with a dentigerous cyst. No recurrence of odontomas was found after surgical excision with follow-up of 1 to 15 years.

Case report: two nasal floor compound odontomas associated with impacted maxillary incisor

AIM

The purpose of this report is to describe the logical sequence of treatment in a case of a six year old caucasian female patient with two nasal floor compound odontomas, that delayed eruption of a maxillary permanent incisor.

TREATMENT

The odontomas were surgically removed. However, as the maxillary incisor did not erupt spontaneously, after a suitable period of observation, an orthodontic treatment approach was adopted. This was to obtain an adequate space for the unerupted tooth and to move it to its normal position.

CONCLUSION

Early diagnosis and surgical intervention of supernumeraries is therefore necessary and treatment of an impacted tooth may require an orthodontic appliance.

Compound odontoma associated with an unerupted and dilacerated maxillary primary central incisor in a young patient

The occurrence of odontoma in the primary dentition is uncommon. There are very few reports of non-eruption of a dilacerated primary tooth in the literature. A rare case of compound odontoma in association with an unerupted dilacerated maxillary primary incisor in a young patient is reported. There was also a developing supernumerary tooth in the vicinity of the odontoma. The clinical features and management of these conditions are discussed. The relevant literature is reviewed. A possible causal relationship between odontoma and dilaceration is highlighted.

Unerupted maxillary primary canine associated with compound composite odontoma: a case report

Unerupted primary teeth is very rare especially in the maxillary anterior teeth. A case of unerupted left maxillary Cuspid due to the presence of compound composite odontoma in a 10 years old female child is presented.

Eruption disturbances of mandibular permanent incisors

In this study, we analyzed 7 eruption disturbance cases of mandibular permanent incisors (5 males and 2 females), aged 5y9m to 10y4m. The etiology was divided into 3 categories: traumatic injuries (3 cases), odontomas (2 cases), supernumerary teeth (2 cases). The procedures such as removal of cause (4 cases), surgical exposure (5 cases) and traction (1 case) were done.

A case of complex odontoma associated with an impacted lower deciduous second molar and analysis of the 107 odontomas

OBJECTIVE

Odontoma is a comparatively common odontogenic tumor, and it may lead to interference with the eruption of its associated tooth. Odontomas are mostly associated with permanent teeth, and they are rarely associated with deciduous teeth. The purpose of this report is to analyze 107 odontomas and to present a case of complex odontoma associated with a lower deciduous second molar.

SUBJECT AND METHODS

The 106 cases were analyzed with regard to the following parameters: age, gender, location, erupted teeth, congenital missing teeth, radiological features, histopathological features and prognosis.

RESULTS

Of the 106 cases, 41 were complex odontoma, 62 were compound odontoma, and three were immature odontoma. Compound odontoma had a predilection for the anterior. Complex odontoma occurred more often at the mandible.

CONCLUSION

Odontoma located above the tooth crown of lower deciduous molar did not behave clinically different from that associated with permanent tooth. An odontoma could be related with a supernumerary tooth or a missing tooth. If odontomas, which interfered with tooth eruption, were extirpated early, the impacted teeth would probably erupt normally and be normal in shape.

Recurrent infection of a complex odontoma following eruption in the mouth

Odontomas are the most common odontogenic tumors, and are classified as either compound or complex lesions. Although its underlying etiology remains unclear, a number of factors appear to be involved (e.g., prior trauma). The lesions are generally diagnosed in the second decade of life, often in the context of routine dental X-ray examinations. A complex odontoma is described in a 22-year-old woman referring discomfort due to overinfection following its aperture into the oral cavity in the distal alveolar region of 2.6. Initial treatment consisted of antibiotics and antiinflammatory drugs. Computed axial tomography revealed a solid, irregular mass in the distal zone of the left maxilla, imprinting upon the region of the maxillary sinus on the same side. Surgical resection was performed, raising the alveolar mucosa and upper left vestibular fundus. The surgical piece contained the amorphous adenoma mass and the tooth 2.7.

Combined benign odontogenic tumors: CT and MR findings and histomorphologic evaluation

SUMMARY

Calcifying epithelial odontogenic tumors and calcifying odontogenic cysts are rare, benign odontogenic tumors. We report two cases of an exceptional combination of these tumors with either an ameloblastic fibroodontoma or an odontoma.