Diminutive compound odontoma in a child: a case report with emphasis on early detection

The odontoma is regarded as a hamartomatous process of the jaws. Most are discovered as an incidental radiographic finding, averaging 15 mm in size. This report describes a case of a diminutive odontoma that was surgically removed before the onset of eruptive and pathologic consequences. A compilation of documented complications and syndromes associated with odontomas is also presented.

Ameloblastic fibro-dentinoma: a rare mixed odontogenic tumor case report with review of literature

BACKGROUND

Ameloblastic fibro-dentinoma is considered a rare, benign, mixed odontogenic tumor that occurs mainly in the posterior mandible in the 1st-2nd decade of life. Although the clinical behavior of Ameloblastic fibro-dentinoma is similar to that of ameloblastic fibroma, there is a debate about whether Ameloblastic fibro-dentinoma is a developing hamartomatous odontoma or a separate neoplastic odontogenic tumor like ameloblastic fibroma. However, it is important to understand the histopathogenesis of this rare tumor.

CASE PRESENTATION

A case report presenting an 11-year-old male child with a swelling in the posterior mandible. Radiographic examination revealed a multilocular lesion with mixed radiodensity related to the impacted lower left second premolar tooth. Incisional biopsy was done, and microscopic examination revealed cords and nests of odontogenic follicles lined by ameloblast-like cells and central stellate reticulum-like cells in the primitive ecto-mesenchymal stroma with areas of dentinoid material and osteodentin. The diagnosis was ameloblastic fibro-dentinoma. Surgical excision of the lesion was done, and the patient was followed up for 1 year without evidence of recurrence.

CONCLUSION

Reporting such a rare entity clarifies the debate about its nature and the importance of early diagnosis of lesions that are associated with unerupted teeth showing how it is effective in early management and prognosis.

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.

Compound Odontoma of the Anterior Maxilla Associated with Displaced Lateral Incisor: A Case Report

INTRODUCTION

Odontomas are the most common odontogenic tumors worldwide and are usually chance findings seen on routine dental examinations. However, on progression, they may be associated with adjacent tooth displacement.

CASE DESCRIPTION

We report a case of an 11-year-old girl who presented at the Lagos University Teaching Hospital (LUTH) pediatric dental clinic with a complaint of painless enlargement of the left anterior maxilla of 2-years duration. The swelling was located between teeth 21 and 22 and was associated with distal displacement and mesial angulation of tooth 22. Clinical, radiographic and histopathologic investigations revealed a compound odontoma. Surgical exposure and enucleation was done to remove the tumor. The patient's postoperative course and 6 months follow-up were uneventful.

CONCLUSION

This report elucidates the importance of routine dental check-ups and minimally traumatic management of odontomas in pediatric dental patients to prevent adverse effects of odontomas, thereby, minimizing the interventions needed after surgical enucleation.

Peripheral ameloblastic fibro-odontoma-Report of 2 cases of a very rare entity

Ameloblastic fibro-odontoma (AFO) is a rare benign mixed odontogenic tumor that affects children and young adults. AFO occurs mainly intraosseous. Extraosseous AFO is extremely rare. We report 2 cases of rare peripheral ameloblastic fibro-odontoma in 2- and 12-year-old female patients. Microscopic examination revealed a benign proliferation of odontogenic epithelium associated with a dentinoid material distributed within a cell-rich mesenchymal stroma resembling dental papilla. Simple surgical excision of the lesion is usually curative. There was no recurrence after a short period of follow-up. Clinicians should be cognizant of this rare entity, which can be considered in a differential diagnosis of gingival growths that are noted in early childhood.

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.

Ameloblastic Fibro-Odontoma

The ameloblastic fibro-odontoma (AFO) is a rare, mixed odontogenic tumor exhibiting the histological characters of the ameloblastic fibroma and complex odontoma. It is comprised of proliferating ectodermal and mesenchymal components of odontogenic tissue as well as enamel and dentin. AFO normally presents as an asymptomatic swelling of the posterior maxilla or mandible and is usually associated with developing teeth, occurring predominantly in children and adolescents. Such lesions are generally found upon radiographic examination of patients whose tooth eruption is delayed. This lesion often includes an unerupted permanent tooth, and extraction of this tooth is a common treatment. The purpose of this report is to describe an AFO in the posterior mandible of a nine-year-old girl for whom enucleation was performed under general anesthesia without extracting the displaced permanent mandibular left second molar. Two years later, the tooth erupted into occlusion without tumor recurrence.

Timing of Surgical Removal of Odontoma in a Growing Orthodontic Patient: A Case Report

In patients with skeletal malocclusion and odontoma, the prioritization of treatment is ofgreat importance. Ifsurgical removal of odontoma is postponed, the probability of adjacent teeth impaction increases. In this case, skeletal treatment was performed before odontoma rgery due to concerns about facial appearance and the patient's fear of surgery, and therefore adjacent tooth failed to erupt.

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.

Metachronous ameloblastic fibro-odontoma and dentigerous cyst in the posterior mandible

An ameloblastic fibro-odontoma (AFO) is a rare mixed odontogenic tumor with histologic features of an ameloblastic fibroma in conjunction with the presence of dentin and enamel. It usually appears as a well-circumscribed radiolucency with radiopaque foci and slow growth and is commonly seen in children and young adults. A 13-year-old boy presented with an asymptomatic swelling in the posterior right region of the mandible and the right ascending ramus. The clinical, imaging, and histopathologic findings confirmed the diagnosis of an AFO. After 8 months, a radiolucent lesion involving the unerupted mandibular left third molar was observed; a final diagnosis of a dentigerous cyst (DC) was established for this lesion. Although coincidental events, metachronous odontogenic lesions suggest a possible common genetic origin, since both can be caused by related cellular signaling pathways. Complete enucleation is recommended for both AFOs and DCs; rates of recurrence are low.

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.

Compound Odontoma in Three Dogs

Three young, female dogs were operated for compound odontoma. All tumors were considered stage III with treatment consisting of partial mandibulectomy or maxillectomy. Microscopic examination of the resected tissue confirmed the diagnosis. Relatively aggressive, resective surgery resulted in prolonged tumor-free intervals.

Management of a Compound Odontoma in the Primary Dentition

Odontomas are the most common benign odontogenic tumors of the oral cavity; however, their occurrence in the primary dentition is an extremely rare condition. When associated with primary teeth, odontomas may lead to disturbances in tooth eruption, which often requires a multidisciplinary treatment approach. The purpose of this paper is to review the literature on odontomas of the primary dentition and discuss the management of a compound odontoma in a pediatric patient.

Peripheral Tumor with Osteodentin and Cementum-like Material in an Infant: Odontogenic Hamartoma or Odontoma?

The purpose of this report is to describe a peripheral tumor on the mandibular alveolar ridge of a seven-month-old Caucasian boy, consisting of ectomesencymal odontogenic tissues, in particular osteodentin and cementum-like material, in a cellular or loose vascular connective tissue stroma. This case may be considered either a peripheral odontogenic hamartoma or a peripheral odontoma.

[Benign odontogenic tumor in the lower jaw: A case report]

Odontomas are classified within the group of odontogenic epithelial tumors with odontogenic ectomesenchyme with or without hard tissue formation. Together with ameloblastomas and keratocystic odontogenic tumors they are counted among the most common odontogenic tumors. Their growth is self-limiting and mostly, they are discovered accidentally as part of a x-ray examination. A common finding is that odontomas are associated with an unerupted permanent tooth. The aim of the present case report is to present the step-by-step procedure of a surgical odontoma removal in the lingual premolar/canine area of the lower jaw.

Lateral Approach for Excision of Maxillary Incisor Pseudo-Odontoma in Prairie Dogs (Cynomys ludovicianus)

AIM

To describe our experience with lateral approach for excision of maxillary pseudo-odontomas and to illustrate surgical outcomes and postoperative complications in seven pet prairie dogs.

MATERIALS AND METHODS

Excision of 11 maxillary pseudo-odontomas was performed in seven prairie dogs with a lateral approach technique and clinical presentation, duration of surgery, time and type of post-surgical complications, presence or absence of symptom recurrence, time to follow-up, overall survival time and causes of death of each case were recorded.

RESULTS

Duration of surgery, postoperative hospitalization and time to autonomous feeding were 54.8 min, 58 h and 1 day, respectively. Recurrence of respiratory symptoms was observed in four cases. Mean follow-up time was 632 days. Six out of seven cases were still alive at the end of the study.

CONCLUSION

The lateral approach to excision showed good and promising results for treatment of maxillary pseudo-odontomas in prairie dogs.

Compound odontoma in the mandible--case study and literature review

INTRODUCTION

Odontomas constitute a developmental defect of hard dental tissues and are classified as benign odontogenic tumours. They are composed of all dental structures and tissues: enamel, dentin, cementum and pulp. As regards histomorphological features, two types of odontomas have been differentiated: complex and compound. Odontomas represent from 4.7% to 76% of odontogenic tumours. Their aetiology has not been fully understood, yet injury, infection and genetic factors are often named among the causes. Odontomas are usually detected by chance in radiographic images taken in relation to disrupted eruption or mislocation of teeth.

AIM OF STUDY

To present the case study of an erupting compound odontoma on the right side of the mandible in an 11-year-old girl.

MATERIAL, METHODS AND RESULTS

The analysis covered medical documentation of the patient, diagnostic casts, orthopantomographs and cone beam computed tomography scans. The case study has been complemented with the review of up-to-date literature. A lesion composed of 30 odontoids was removed during one-day surgery without subsequent augmentation with bone substitute material. There were no post-surgery complications. A follow-up orthopantomograph taken 3 months later showed that the wound had been healing correctly, which made it possible to plan subsequent orthodontic treatment with a fixed appliance.

CONCLUSIONS

1. Odontomas are benign lesions which can be removed during one-day surgery without the absolute need of augmentation with xenogenic or allogenic material. 2. The pressure exerted by the plate of a removable appliance is very likely to initiate the eruption of the odontoma.

An idiosyncratic post-traumatic tetrad: compound odontome, dentigerous cyst, impaction, and double-dilaceration

OBJECTIVE

This report describes the case of a 13-year-old patient who experienced traumatic intrusion of the primary maxillary right central incisor and subsequently suffered an atypical tetrad, comprising of an unerupted compound odontoma associated with a dentigerous cyst, and an impacted, doubly dilacerated permanent maxillary right central incisor; however, the high interconnectivity of the occurrence of four pathologies together is unusual has not previously been reported.

SUMMARY

The pathologies were detected 7 years after trauma; surgical removal of odontome along with the dentigerous cyst was performed, followed by orthodontic extrusion of the impacted double-dilacerated permanent central incisor. The 18-month follow-up shows no pathology, no gingival recession, and normal probing depth.

Compound odontoma involving the four quadrants of the jaws: a case report and review of the literature

Odontomas are the most common odontogenic tumors, representing 70% of all odontogenic tumors. They may present in two specific forms; compound odontoma forms multiple small tooth-like structures, while complex odontoma forms an amorphous calcified mass. In this report, we present a 27-year-old male patient with multiple compound odontoma occupied regions at his jaws. The odontomas involve both alveolar and basal processes of the maxilla and mandible as well as both maxillary sinuses. Converse to conventional recommended treatment, which is surgical excision of the lesion, the management was removal of the lesion and clinical-radiologic followup. The first year's follow-up findings are presented in this case report.

Clinical, radiographic, and histologic presentation of fibrodentinosarcoma

A general dental practitioner should be familiar with certain rare odontogenic entities like fibrodentinosarcoma, which can occur with unerupted or impacted teeth. The knowledge of such rare pathologies usually associated with unerupted/ impacted teeth aids in the early recognition and correct management of these entities, which are often asymptomatic. One such rare, diverse tumor is ameloblastic fibrodentinosarcoma (AFDS), characterized only by sporadic case reports in the literature. It is important to describe the features of this odontogenic entity to general dental practitioners for successful management and to reduce patient morbidity. This report presents a case of AFDS in a 17-year-old woman who reported to our department with a swelling of the right mandible that was associated with an unerupted tooth. The clinical, radiographic, and histologic findings of AFDS are presented, providing the details necessary to assist the primary dental clinical team in management of AFDS.

Surgical treatment of extensive complex odontoma in the mandible by corticotomy. A case report

Odontomas represent the most prevalent odontogenic tumors in the jaw. The treatment of choice is surgical removal, usually performed by conventional techniques involving ostectomies to expose the tumor. In this paper, the authors describe, through the report of a case of complex odontoma located in the mandibular angle, a more conservative surgical technique called corticotomy, in which the bone removed for access to the tumor (buccal cortical) is repositioned and fixed by titanium plates of 1.5 mm.

Ameloblastic fibrodentinoma with a congenitally missing second premolar tooth: a case report

Ameloblastic fibrodentinoma (AFD) is a rare benign mixed odontogenic tumor that occurs predominantly in children and young adults. AFD is usually associated with delayed eruption of the tooth and shows painless swelling. We present a case of AFD affecting an 8-year-old Japanese girl with a complaint of delayed eruption of her left mandibular second premolar tooth. Intraoral examination did not reveal any sign of pain or swelling in the left mandible. Panoramic radiography revealed a radiolucent and well-circumscribed lesion, which contained radiopaque material at the premolar lesion of the left mandible. The second deciduous molar tooth was unerupted and the second premolar tooth was congenitally lacking. Our provisional diagnoses were odontogenic tumor. The biopsy confirmed AFD. The treatment included total excision of the tumor and the second premolar tooth. No recurrence has been noted during the 2 years of follow-up.

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.

[Surgical tactics by various ameloblastic tumors]

Ameloblastoma and ameloblastic fibroma are benign odontogenous tumors of the jaws with local destructive growth, prone to recurrence. They have various typical radiological and histological features. Surgical tactic generally includes partial resection of the affected jaw. Immunohistochemical study of the tumor tissues allows assessing the expression of tumor progression markers and forecasting tumor growth thus providing individual choice of surgical tactics. Our experience in treatment of ameloblastic tumors showed total biopsy with osseous surgical margins resection to be sufficient for normal bone structure remodeling in some patients.

[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.

Ameloblastic fibro-odontoma in children: report of 2 cases

Ameloblastic fibro-odontoma is a rare, mixed, benign, odontogenic tumor of significant prevalence in the mandible, with epithelial and mesenchymal components. It usually affects pediatric patients and is associated with teeth, causing a delay in eruption chronology or an alteration in the dental eruption pathway. It is occasionally diagnosed during radiographic evaluations of these patients. The literature is unclear whether it is a distinct pathological entity or a stage of odontoma. As it is benign and has a low recurrence rate, conservative treatment is recommended. The purpose of this paper was to present 2 cases of ameloblastic fibro-odontoma in the mandibles of children.

Maxillary reconstruction with particulate bone graft and titanium mesh: a treatment option for large complex odontoma of the maxilla

Odontomas are the most common type of odontogenic tumor and are generally asymptomatic. The purpose of this paper was to describe the case of a complex odontoma in a patient who had asymptomatic swelling in the central maxillary region, along with unerupted central and lateral incisors. In this case, surgical excision of the lesion was performed and an iliac bone graft was introduced into the defect area with a titanium mesh covering up the grafted harvesting bone. After 2 years of followup, no recurrence was identified. Patient followup is still in progress to evaluate bone graft resorption, and the patient awaits complete bone development. Oral rehabilitation with an osseointegrated titanium implant is expected in the future. An option of the large complex odontoma treatment is discussed.

[A case reported of an ameloblastic fibroma in which involved three right molars in a teenager]

Ameloblastic fibroma is a benign tumor of mixed odontogenic origin, which occurs in ages from 12 to 15 years, frequently in the molar area. Generally it is asymptomatic, however the biggest lesions can be associated to pain and swelling. Using X-ray they appear well defined, transparent, with a sclerotic radio-opaque border; occasionally they can simulate a dentigerous cyst. The treatment is generally conservative. This report describes an ameloblastic fibroma in a 14-year-old male, which involved the three right molars and both the ascending ramous and the coronoid process, which was treated conservatively with the extraction of the affected teeth, tumor extirpation and osseous curettage.

Two-stage surgical removal of large complex odontoma

PURPOSE

The surgical treatment of a large complex odontoma in the mandibular angle is reported. Four possible surgical approaches to remove a benign tumor in the mandibular angle are discussed.

PATIENT

A two-stage surgical treatment was chosen; first, removing most part of the lesion and preserving the second molar, decreasing the risk of a pathological mandibular fracture. A maxillo-mandibular fixation for a period of 4 weeks was used. The patient was oriented to maintain a soft diet. The second surgical stage occurred 3 months after the first one due to the significant bone consolidation observed, reducing the possibility of a mandibular fracture. The remaining lesion and the second molar were then completely removed.

CONCLUSIONS

This case demonstrates the value of the tridimensional computed tomography in treatment planning prior to any definitive surgery. A computed tomography should be made in every case of intraosseous lesion in order to establish the intraosseous extent of the tumor, cortical perforation, and soft tissue involvement for precise guidance for the surgical planning. It is recommended that the surgeon considers excision by an intraoral, lingual approach when indicated, and in two stages, when an extremely thin mandibular base is present.

Small peripheral developing odontoma of the maxilla in a 3-year-old patient depicted on cone-beam tomograms

A 3-year-old male patient was referred to the Maxillofacial Surgery Clinic due to a painless swelling of the right palatal region. Conventional radiographs revealed no alteration of the dentition and did not delineate a lesion in the region of interest. Cone-beam tomography depicted small radiopaque, extraosseous deposits inside the palatal space. Histological examination revealed a minute mixed epithelial-mesenchymal lesion of odontogenic origin. We made the diagnosis of a peripheral developing odontoma, taking into consideration the components and arrangements of structures of the lesion. Early intervention is advisable to prevent these odontogenic lesions from eventually deforming the jaw and displacing adjacent teeth. Cone-beam tomography was a valuable pre-operative diagnostic tool to assess the lesion as being composed in part of hard tissue.

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.

Compound odontoma

A case of compound odontomas of the anterior maxilla is discussed. Multiple tooth like structures were discovered upon surgical excision.

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.

Complex odontoma

Odontomas are hamartomatous lesions or malformations composed of mature enamel, dentin, and pulp. They may be compound or complex, depending on the extent of morphodifferentiation or their resemblance to normal teeth. The etiology of odontoma is unknown, although several theories have been proposed. This article describes a case of a large infected complex odontoma in the residual mandibular ridge, resulting in considerable mandibular expansion.

Radiologic evaluation of an unusually sized complex odontoma involving the maxillary sinus by cone beam computed tomography

As a group, odontomas are the most common odontogenic neoplasms. This case report illustrates the benefits of cone beam computed tomography, in terms of treatment planning and surgical technique, to localize a large maxillary odontoma and accurately establish its relationship with the maxillary sinus and molar.

Erupted odontomas: a report of three cases and review of the literature

INTRODUCTION

Odontomas are benign odontogenic tumors composed of enamel, dentine, cement and pulp tissue. They are usually clinically asymptomatic, but often associated with tooth eruption disturbances. In exceptional cases the odontoma erupts into the mouth . The present study reports three cases of odontomas erupted into the oral cavity and reviews the literature.

CLINICAL CASES

The first case was an 11-year-old girl with impacted 4.6 associated to a radiopaque mass measuring about 2 cm in diameter. The histological diagnosis was complex odontoma. A clinical and radiological follow-up of 4.6 was carried out until its spontaneous eruption. The second case was a 26-year-old male presenting a hard, yellowish-brown mass located distal to the upper left second molar. Computed tomography confirmed the presence of a radiopaque lesion, and the histopathological study confirmed a complex odontoma. The third patient was a 27-year-old male reporting tongue irritation due to tooth eruption in the inferior lingual region. A periapical radiograph revealed a mixed radiopaque lesion associated to impacted 3.2. The histological report in this case indicated a compound odontoma.

DISCUSSION

Odontomas erupting into the oral cavity are rare. The first case was published in 1980, and since then only 17 cases have been reported in the literature. Eight of the 17 cases were complex odontomas; the rest were compound odontomas. Pain, swelling and infection were the most common symptoms, and 13 cases presented an impacted tooth associated with the lesion.