Title : A complex odontoma in a paediatric patient with hypodontia
Abstract:
Background: A complex odontoma is a benign odontogenic tumor of the jaw, consisting of a disorganised mass of dental tissue. Aetiology remains unclear and there have been reports of a potential association with trauma or infection, as well as a genetic component. They are often asymptomatic and usually identified incidentally upon radiographic investigation of an unerupted tooth or retained deciduous tooth.
Patient Information: We report a case of a 12 year old male who was referred to our department regarding an infra-occluded LRE with no permanent successor. Radiographic investigations showed a lobulated sclerotic mixed lesion with some areas resembling dental enamel, distal to the developing LR7, in addition to mild expansion of the mandibular ramus. Clinically, there was no evidence of swelling or bony expansion and normal sensation was reported.
Management and Outcome: The lesion was subsequently surgically excised under general anaesthetic and histological findings reported fibrofatty connective tissue together with a small amount of likely tooth matrix material. 6 months post-operatively, a repeat OPG showed bony infill in this region with no evidence of recurrence.
Audience Take Away:
- This presentation will highlight important aspects of the clinical and radiographical signs of a complex odontoma to facilitate prompt management.
- Complex odontomas have the potential to affect the eruption of teeth; cause displacement as well as resorption of adjacent teeth, in addition to bony expansion. To avoid such complications, early detection and diagnosis is key to allow appropriate management, usually through surgical excision.
- As the likelihood of recurrence is rare due to the well-capsulated nature of these masses, conservative surgical excision is the preferred approach.
