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Panoramic radiograph shows the lesion as a well-defined radiopacity surrounded by a radiolucent halo with secondary inferior displacement and oblique horizontal impaction of the right mandibular second premolar.
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Odontomas are nonaggressive, hamartomatous developmental malformations composed of mature tooth substances and may be compound or complex depending on the extent of morphodifferentiation or on their resemblance to normal teeth. Among them, complex odontomas are relatively rare tumors. They are usually asymptomatic in nature. Occasionally, these tum...
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... 2,4 The aetiology remains unclear and there have been reports of a potential association with trauma or infection, as well as a genetic component. 5,6,7 Furthermore, there have been links to hereditary conditions such as Gardner's Syndrome and Hermann's Syndrome, in which multiple odontomas may be found. 1,3 ...
... 5,8,9 They have the ability to cause bone expansion and facial asymmetry but rarely erupt into the oral cavity, however if they do, can lead to pain, inflammation and infection. 3,5,6 Additionally, due to their common association with an unerupted tooth, they may cause impaction/delayed eruption, displacement and/or resorption of adjacent teeth/structures. 6 To avoid such complications, it is important that these lesions are identified early and managed appropriately, usually through surgical excision. ...
... 3,5,6 Additionally, due to their common association with an unerupted tooth, they may cause impaction/delayed eruption, displacement and/or resorption of adjacent teeth/structures. 6 To avoid such complications, it is important that these lesions are identified early and managed appropriately, usually through surgical excision. 4,5 As the likelihood of recurrence is rare due to the well-capsulated nature of these masses, conservative surgical excision is the preferred approach. ...
The complex odontoma is a benign odontogenic tumor of the jaw, consisting of a disorganised mass of dental tissue with unknown aetiology. They are often asymptomatic and usually identified incidentally upon radiographic examination. However, they have the potential to cause displacement and resorption of adjacent teeth as well as affecting tooth eruption, therefore early identification is important. We report a case of a 12 year old male who was referred to our department with an incidental finding of a complex odontoma in the mandible.
... 11 Further, odontomas may be associated with a myriad of other oral and maxillofacial developmental complications and pathologic processes (Box). [2][3][4][5][6]9,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] Because most odontomas are asymptomatic, lesions may go undetected and ultimately be found after achieving a considerable size. 19,20 Odontomas also may occur in association with several syndromes, primarily Gardner syndrome (multiple osteomas, supernumerary teeth, colorectal polyps/increased risk for colorectal cancer), odontoma dysphagia syndrome (esophageal stricture/dysphagia, oligodontia, mild facies, misshapen teeth), otodental syndrome (globodontia, hearing loss), SATB2-associated syndrome (delayed speech, intellectual disability, facies, hypodontia, taurodontia, cleft palate), and Noonan syndrome (short stature, cardiac malformations, webbed neck, facies, central giant cell granulomas of the jaws). ...
... Despite their benign nature, their eruption into the oral cavity can give rise to pain, inflammation, infection and ulceration but large odontomas can cause cortical expansion, facial asymmetry and traumatic ulcers. Therefore, it is important to diagnose these lesions as soon as possible and treat them appropriately as to avoid complications [9]. ...
Odontomas are the most common benign odontogenic tumors (35%-76%). Originating from an alteration of differentiated mesenchymal and epithelial odontogenic cells; they can form enamel, dentin, and cement. They are classified into compound and complex, in a 2:1 relationship, the difference between both being dental tissue organization. Etiology is still unknown but the relation to infections, hereditary anomalies, odontoblastic hyperactivity and trauma has been explored. Since these tumors are asymptomatic, 75% of all cases are diagnosed before the second decade of life, due to a delay in eruption of permanent teeth. The treatment of choice for these tumors is enucleation, attempting to preserve the tooth; relapse is very uncommon. Diagnosis of odontomas is usually accidental on radiographic examination. This article presents and discusses the case of a 70-year-old female patient who complained of replacing her missing teeth. A Radio-opaque calcified mass was revealed on a radiograph and was surgically removed. Here, we report the case of a painless, complex odontoma located in the right anterior mandible.
... It has been reported that the complex odontoma can rarely erupt because it lacks periodontal ligaments. Its appearance in the oral cavity is a consequence of bone sequestration from its growth [5]. ...
Background
Compound odontoma (CpOD) develops tooth germ-like structures but often lacks complete differentiation. Some authors recognize the compound odontoma as supernumerary teeth.
Objective
This study aimed to present the analysis of orthodontic problems and radiological findings in three clinical cases of patients with complex odontoma.
Case Presentation
The present three clinical cases of patients (two females and a male), aged from 14 to 25 years, had compound odontoma, which was confirmed through their radiological findings. Patients did not report symptoms associated with pain and discomfort in the area or genetic predisposition in the family. Orthodontists examined each clinical case with its individual problems and solutions. The findings were localized in the canine region, in 2 of the cases in the upper jaw and one in the lower. Only one patient with localization of the problem in the lower jaw had no disturbance in the eruption of the teeth in the affected dental arch, while in two patients with localization of the problem in the upper jaw, retention of permanent canines was found. In all three cases of the odontoma, there was one tooth with the reverse direction of the crown root. In one case, a supernumerary tooth near the odontoma was also observed. In all of the presented cases involving compound odontoma, there was one main well-formed and developed tooth, around which the other tooth-like structures were located, usually with a conical shape.
Conclusion
CBCT contributes to establishing an accurate and detailed morphological characterization of the fundamental structures (teeth) in the odontoma.
... Such odontomas can be discovered at any age but the age with the highest prevalence is the second decade of life [3] . These tumors have a male predilection and are frequently observed in the posterior mandible [4,5] . Compound odontoma seldom erupts in the oral cavity. ...
... Multiplane and three-dimensional CT imaging elucidates the accurate extent of the disease [13] . On radiograph, these tumors appear as well-defined radiopacity surrounded by a radiolucent rim representing the connective tissue of the dental follicle [4] . We report this interesting case of a large erupted compound odontoma, which was associated with the ulceration of the buccal mucosa. ...
... Corticosteroids can be administered after surgical removal of odontoma to reduce post surgical pain as corticosteroids are a class of compounds secreted endogenously by the adrenal cortex and manufactured as synthetic analogues for therapeutic use, predominantly because of their powerful anti-inflammatory and immunosuppressive properties [18][19][20] . In children, the impacted permanent teeth, depending on the age of the child and the stage of tooth development, may be left to erupt by itself or may be guided to occlusion via orthodontic traction [3,4] . In any case, follow-up is essential following odontoma excision. ...
Odontoma or odontome is the most common odontogenic tumor in oral cavity. Complex odontomas are commonly found in the posterior mandible region. Complex odontoma or fibro odontoma is most commonly located in anterior maxilla. Odontoma are hamartoma comprised of various dental tissues, that is, enamel, dentin, cementum, and occasionally pulp. Odontoma are slow-growing, benign tumors. The World Health Organization (WHO) outlines odontomas as two types-complex odontoma and compound odontoma. Complex odontoma very rarely erupts in the oral cavity. We report this interesting case of a large erupted complex odontoma in anterior maxilla. Key words: odontoma, odontome, complex odontome, benign tumor, fibro odontoma, odontogenic tumor, hamartoma
... Odontomas are considered to be developmental hamartomas rather than true neoplasms of odontogenic origin 8,9 because a neoplasm has the distinguishing feature of persistent, uncoordinated growth. However, many diagnosed odontomas become sufficiently large to show almost neoplastic potential and cause vari-ous complications, such as the expansion of the jaw bone, tooth displacement, or missing teeth, 10,11 and even signs of infection, pain, and suppuration. 11,12 Indeed, whether these odontogenic lesions represent a true neoplasm or only a hamartoma is still not well established and requires additional studies. ...
... 2,16 However, studies focused on odontomas have been poorly documented, 7,12,16 except for the published case reports. 10,17,18 In addition, most studies have not adequately investigated the characteristics of odontomas in terms of their clinical and radiographic aspects and have even failed to consider these features in the context of the distinct complex and compound subtypes. 14,15 Thus, it would be inaccurate to compare the outcomes of these various studies without accounting for subtype or sex. ...
... A previous study demonstrated that the majority of odontomas measured in the range of 10-30 mm, 25 and occasionally, a CxOD exceeded 40 mm in diameter. 10,11 These outcomes are in accordance with the results of the present study, in which 62% of odontomas had a size of 10-30 mm and only 8% of cases (7/90) showed a dimension of ≥40 mm. Furthermore, this study found that CxODs were larger than CpODs, which may be related to the older age at diagnosis of CxOD than CpOD (Fig. 2). ...
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.
... The final stage is a radiopaque lesion surrounded by a radiolucent ring lesion. 21 This final stage of calcification is commonly wrong to diagnose. ...
... There is no specific age preference for the incidence of complex odontoma. Still, Kodali et al. 21 and Jadav et al. 38 said that the average case of Complex Odontoma occurred in the second decade of life. ...
Objectives: This review article is aimed to determine panoramic radiograph images of complex odontoma images involving impacted teeth. Review: This study is a scoping review consisting of English or Indonesian articles of complex odontoma in impacted teeth and published in 2010 – 2021. The article search databases used were PubMed, Science Direct, EbscoHost, and Clinical Key with the keyword “(((Complex Odontoma) AND Impacted teeth) AND panoramic radiograph).” The selected articles were screened by checking the publication year, duplicating articles, reading the titles and abstracts, and the entire article's contents. The total search results for articles based on keywords obtained were 621 articles, then 11 articles were used. In all articles covered, the number of impacted teeth is 45, dominated by 32 maxillary and mandibular molars. The majority of lesions formed on the maxillary and mandibular posteriors were not associated with other abnormalities. The majority of the lesions affect the growth of the surrounding teeth and extend to the surrounding jawbone. Conclusion: Panoramic radiographs of Complex Odontoma involving impacted tooth in the form of a homogeneous radiopaque lesion with an oval or irregular shape with a lesion density more significant than bone and surrounding tissue. A well-defined radiolucent lesion surrounds this radiopaque lesion in the form of a connective tissue capsule.
... 7 Complex odontomas are a type of odontoma that appears on standard radiographic examination as a tiny, asymptomatic radiopaque mass surrounded by a radiolucent halo. 8,9 Majority of all odontomas are detected during the first two decades of life. They account for 22-67% of all https://doi.org/10.18231/j.adr.2022.011 ...
Odontomas are categorised into mixed odontogenic tumor that originates ecto-mesenchymally and made up of mineralised tissue. Hamartoma is the most frequent benign tumour with an odontogenic aetiology. It is distinguished by its sluggish growth and lack of aggression. "Erupted odontomas" are those that erupt into the oral cavity and are uncommon. They are usually noticed in regular radiography and can be caused by a variety of factors, including trauma, genetic mutations, or infection. They are categorised into complex and compound types. Erupted Complex Odontomas are rarely ensued into the oral cavity. The present case report is of such unusual erupted complex odontoma, where 17-year-old male patient reported with history of pus discharge from the left side of the face. This report is of clinical importance because it was associated with impacted tooth & agenesis of adjacent molar tooth which is usually rare. We provide clinical and radiographic findings as well as treatment for a unique instance of a massive erupted complicated odontoma in the maxilla.
... On reviewing cases of giant complex odontoma of mandible in the literature, we have found that only 15 cases were reported heretofore [4,8,[15][16][17][18][19][20][21][22][23][24][25][26][27] (Table 1). Seven patients (46.7%) were females, and eight (53.3%) were males. ...
... This radical excision, even with thinning and expansion of mandibular bony plates, was unjustified. Based on the literature and this report, more conservative surgeries were very predictable [4,22,23,25]. Piezoelectric technology could be used in removing the external cortical bone and exposing the lesion to avoid potential damage to the inferior alveolar nerve [17]. Some surgeons preferred to remove the large lesions by blocks to reduce morbidity [17,27]. ...
Introduction
and importance: Complex odontomas are hamartomas representing a conglomeration of all dental tissues. When developed, they rarely become giant and even more rare to become giant in children. This report presented an unusual giant mandibular complex odontoma in very young patient. It also provided a literature analysis and better understanding of clinical features of such giant lesions in the mandible.
Case presentation
An 8-year-old boy presented with swelling in the right side of the mandible. After clinical and radiological exams, a provisional diagnosis of giant composite odontoma was made. This lesion led to jaw expansion, asymmetrical face, and teeth eruption alterations. Surgical excision of the lesion was performed, and histopathological examination confirmed the diagnosis. The patient's follow-up showed that normal jaw size and facial symmetry was restored with no evidence of recurrence for 3 years.
Clinical discussion
A literature review of reported mandibular large odontomas was made. All published reported cases of giant odontoma in the mandible caused bone expansion with or without pain. According to the literature, this paper described the youngest patient with giant complex odontoma in the mandible. This was also the first reported case from Syria.
Conclusion
Giant complex composite odontoma of the mandible can develop at any age causing facial asymmetry, however, with good prognosis and predictable surgical treatment.
... Odontomas are also known as "composite" because they consist of more than one type of tissue. [7] It is mostly manifested as asymptomatic and is diagnosed by routine radiographs of the site. The WHO in the year 2017 broadly classified odontomas into two types: compound and complex. ...
... Within the calcified mineralized masses, the pulp tissue, epithelial remnants, and enamel matrix are present. [1] It is reported that the ratio of compound to complex odontomas [2,7,9] Compound odontomas are usually located in the anterior maxilla, either above the crowns of unerupted teeth or between the roots of erupted teeth. Conversely, complex odontomas are generally found in the posterior mandible, about 10%-44% of a complex odontoma is associated with impacted teeth of the posterior mandible (Soluk Tekkesin et , 1996). ...
... Conversely, complex odontomas are generally found in the posterior mandible, about 10%-44% of a complex odontoma is associated with impacted teeth of the posterior mandible (Soluk Tekkesin et , 1996). [4,7,10] In 45% of cases, the excision of the odontoma mass in the primary operation results in the eruption of the unerupted tooth. [10] There is the morphology of the tooth space available in the dental arch, location in the jaw, and age of the patient are several factors which determine the fate of the unerupted tooth. ...
