They consist microscopically of all the tissue types found in a developed tooth. Compound odontoma in anterior case report mandiblea. This paper discusses a case report of a complex odontoma exhibiting all the structural. Module introduction to histopathology histology and cytology 2 notes once the diagnosis is made, the slides come back to the laboratory. Odontomas are usually asymptomatic with slow growth rate and associated with impacted or delayed eruption of teeth 4. They are usually asymptomatic and diagnosed on radiographic examination.
University of illinois, college of dentistry introduction odontomas are tumors composed of one or more of the various elements that make up tooth structure. Case report complex odontoma associated with dentigerous cyst. Description of the case a 25yearold man was seen at the surgery and. Tumoural and cystic lesions are common findings in the daily practice of dental professionals and maxillofacial radiologists. Three main groups of odontomas have been distinguished. Histologically similar to the layering of normal tooth in the relation of dentin, enamel matrix and pulp. One hundred sixty odontoma cases sent to the institute of oncology. Odontomas usually occurs in 2nd and 3rd decade with female predilection for complex odontomas 68% while compound odontomas shows no gender predilection 6.
The eruption and infection of odontomas are uncommon and very few cases are reported in the literature. The most extreme form of dens invaginatus is known as a dilated odontoma. Odontoma compound odontoma, complex odontomas, odontogenic hamartoma. These are considered to be hamartomatous malformation rather than true neoplasm and are generally asymptomatic. The size and features of surgical pathology gross room depend on the. Odontoma tumor types, diagnosis, histology, treatment and. The number of denticles removed during enucleation of odontomas ranged from 4 to 37. Odontoma can also occur as a component of coc about 20% of coc associated with odontoma odontoma is composed of dental hard tissues. According to 1992 who classification of odontogenic tumours, there are four odontogenic tumours with mixed tissue, that is, ameloblastic fibroma, complex odontoma, compound odontoma and ameloblastic fibroodontoma. Odontoma is the most common odontogenic tumor of the mandible, accounting for approximately 67% of all cases, 6.
A case of impacted central incisor due to dentigerous cyst. Management of complex erupting odontoma in the maxilla. Histopathological insight of complex odontoma associated with a dentigerous cyst. Description of the case a 25yearold man was seen at the surgery and oralmaxillofacial traumatology service, department of. These clinically asymptomatic tumors are classified into complex and compound odontomas. This was seen in our case in the orthopantgram resembling complex odontoma radiographic finding. Muruganandhan, 1 shaikshamsudeen, 1 nalinkumar, 1 m. Complex composite odontoma with characteristic histology. The odontoma is a benign odontogenic tumor combining mesenchymal and epithelial dental elements. Histopathology showed complex odontoma associated with a dentigerous cyst.
Slides are filed for future reference or teachingresearch for at least. There are two types of lesions which are regarded as complex odontomas with a prominent soft tissue component resembling ameloblastic fibroma. The condition is frequently associated with one or more unerupted teeth. Cebi, radiologic evaluation of an unusually sized complex odontoma involving the maxillary sinus by cone beam computed tomography. An odontoma also termed odontome is a benign tumour of odontogenic origin i. There might be a missing tooth if it arises from a normal tooth follice. Chong heon lee, department of oral and maxillofacial pathology, dental. Specifically, it is a dental hamartoma, meaning that it is composed of normal dental tissue that has grown in an irregular way. The location of the odontoma differed based on the type compound odontoma was found more in anterior maxilla region when compared to complex type. Jan 31, 2014 in addition, complex odontomas bear a radiographic resemblance to osteoblastomas, ossifying fibromas and even osteomas. Odontoma, complex odontoma, compound odontoma, odontogenic tumor, impacted.
Complex composite odontoma with characteristic histology sujatha govindrajan, 1 j. It tends to occur in 70% in the posterior region of the mandible. Pdf odontomas are the most commonly occurring odontogenic tumors, which are considered by many to be hamartomas rather than. A 2yearold morgan stallion was brought to the attention of the referring veterinarian when the owners noticed evi dence of pain and irritation on using the bit. Differential diagnosis made on the basis of clinical and radiological examination were ameloblastic fibro odontoma, calcified odontogenic cyst, pindborgs tumour and complex odontoma with dentigerous cyst. Surgical excision is the treatment of choice with an endoscopic approach, if feasible.
Clinical and histopathological investigation of odontomas. Specifically, it is a dental hamartoma, meaning that it is composed of normal dental tissue that has grown in an irregular way the average age of people found with an odontoma is 14. Histopathology of complex odontoma, disorganized mass of dentinlike material and enamel prisms. Jun 27, 2019 compound odontoma and unerupted a dentigerous cyst containing an ectopic canine tooth below the floor of the maxillary sinus. Complex composite odontoma with characteristic histology sujathagovindrajan, 1 j.
There are two general types of odontoma, some are more serious than others. However, simultaneous lesions are rare and represent a diagnostic challenge to overcome. Complex odontoma is a lesion in which all the dental hard tissues are represented but occur in a disorderly pattern. The only real treatment for complex odontoma is to have surgery to remove them. Odontomas are the most common benign tumours of odontogenic origin. In complex odontoma, the enamel, dentin, and cementum are present in a disorganized manner, whereas in compound odontoma, varied numbers of toothlike elements are present. Case report complex composite odontoma with characteristic. Complex odontoma has been known to have a slight predilection towards females, whereas compound odontoma is more common in males, contrary to previous reports that claimed there was no gender predilection 2, 4. A complex odontoma has no specific sequence for all of the dental tissue. One of the tumors of odontogenic epitheliumthis group of tumors is composed of proliferating odontogenicepithelium in a cellular ectomesenchyme resembling the dental papilla. The article also aims to report that intra oral approach for removal of odontomas complex or compound small or large is better than extra oral approach.
Complex odontoma definition of complex odontoma by medical. As with normal tooth development, odontomas stop growing once mature which makes them benign. They are normally diagnosed on routine radiographs, due to the absence of symptoms. Pdf complex composite odontoma with characteristic histology. This paper presents a case of complex odontoma associated with dentigerous cyst in relation to a retained deciduous tooth in the maxillary.
Open access case report cystic complex odontoma a case report. The etiology of odontoma is not known but environmental causes such as infection, trauma, family history and genetic mutation are hypothesized. Muruganandhan, 1 shaik shamsudeen, 1 nalin kumar, 1 m. Complex odontomas were found more commonly in posterior maxilla region. Sultana, large complex odontoma of mandible in a young boy. The tissue undergoes a series of steps before it reaches the examiners desk to be thoroughly examined microscopically to arrive at a particular diagnosis. Differential diagnosis made on the basis of clinical and radiological examination were ameloblastic fibroodontoma, calcified odontogenic cyst, pindborgs tumour and complex odontoma with dentigerous cyst. World health organization defines a lesion as the complex odontoma. Although the exact etiology is unknown, the postulated causes include local trauma, infection, inheritance, genetic mutation.
Pdf histopathological insight of complex odontoma associated. When the diagnosis has been established, odontomas must be removed as they may cause cystic formation with later delay of permanent dentition and bone destruction. However, unlike these studies 5,8, complex odontomas in malaysians showed a preference for the fig. Odontoma complex and compound difference and pictures. It is composed of dentin, cementum, pulpal tissue and enamel. Odontoma by definition alone refers to any tumour of odontogenic origion. We present a case of a large complex odontoma with mandibular 3 rd. Clinical and histopathological investigation of odontomas joms. Apr 28, 20 more complex odontoma are found in males up to age 30. Odontoma, turbinate, ectopic, complex, compound, dentin, odontogenic, rhinosinusitis. After the reports are sent to the surgeons either as soft copy or hard copy, the laboratory has to perform the following functions 1.
They are usually discovered in radiographs and rarely cause bony expansion or infection. A complex odontoma does not usually show any external symptoms. Histologically, the odontoma is not a diagnostic dilemma. Both have radiolucent rims, representing dental follicular tissue or, less commonly, a dentigerous cyst. This paper reports a clinical case of complex odontoma in the maxillary sinus as a cause of chronic sinusitis lasting for years. Reminder of important clinical lesson case report histopathological insight of complex odontoma associated with a dentigerous cyst madhusudan astekar,1. Complex odontoma causes, diagnosis, treatment, pictures. At the cellular level it appears as mostly tubular dentin that encloses hollow spaces. On excision of odontoma along with the extraction of impacted tooth, the clinicians face a challenge for dental rehabilitation of the patient for not only for extracted tooth but also for missing teeth.
Kjellman, stockholm, sweden royal school of dentistry t jlh e term odontoma was introduced by broca as early as 1863. They are normally revealed when the dentist takes xrays and looks at the xrays. These circular spaces are decalcified but they once held enamel. In complex odontomas, all dental tissues are formed, but appeared without an organized structure, as amorphous conglomerates of hard tissue 5. We present a case of a large sequestrating complex odontoma resulting in facial asymmetry, cellulitis, pain and partial loss of. Complex composite odontoma a clinical and histologie report eu olech, d. The most common approach for management of maxillary odontogenic neoplasms is a transoral. The compound odontoma resembles multiple tiny tooth structures, while the complex odontoma appears as a dense irregular mass. Surgical management of odontoma of anterior maxilla. Compound odontoma was more common 60% than complex odontoma. Complex odontomas appear as a radiodense mass of hard tissues which may result in a broader differential diagnosis.
Compound odontoma complex odontoma ameloblastic fibroodontoma peripheral odontoma. Aug 20, 2015 complex odontomas appear as a radiodense mass of hard tissues which may result in a broader differential diagnosis. It includes 2 types, the compound and complex odontomas. Odontomas are the most common benign tumors of odontogenic origin.
The lesion consists of various tooth components, including dentin and enamel, which have developed abnormally to form a hamartomatous lesion. This paper reports two cases of complex odontomas with such unusual features. The purpose of the present study was to evaluate the clinical and histopathologic aspects of different types of odontomas. Oral pathology general section complex odontoma report of a case c0 henriksson and 0. It includes both odontogenic hard and soft tissues. In addition, complex odontomas bear a radiographic resemblance to osteoblastomas, ossifying fibromas and even osteomas. Histopathologic evaluation confirms the diagnosis especially in cases of complex odontoma, which may be confused during radiographic examination with an osteoma or other highly calcified bone lesions. The goal of this article is to report two cases of the complex odontomas erupted in oral cavity and compound odotome with impacted teeth. A large developing complex odontome amin 2017 oral. Mar 17, 2017 odontoma complex and compound difference and pictures dr. We present a case of a large sequestrating complex odontoma resulting in facial asymmetry, cellulitis, pain and partial loss of function. Calcifying odontogenic cyst of anterior maxilla with. Complex odontoma associated with dentigerous cyst in. Rylee smith, md march 17, 2017 the term odontoma was first described by broca in 1866 as a benign odontogenic tumor of epithelial and mesenchymal origin characterized by slow growth and dental contents enamel, dentin, cementum, and pulp.
B macroscopic image of compound odontoma constituted by a capsule of fibrous tissue and multiple denticles. The who classification on odontogenic tumours defines it as a malformation in which all dental tissues are represented, individual tissues being mainly well formed but occurring in a more or less disorderly pattern, and are classified as compound or complex. Odontoma is the most common benign tumor of odontogenic origin, characterized by mixed histological features and diverse clinical presentation. Both complex and compound odontomas were found more on the right side of the jaw, the reason for which is not known. Compound odontoma complex odontoma ameloblastic fibro odontoma peripheral odontoma.
With similar presentation and treatment outcomes to complex odontomas. We report a rare case of a large developing complex odontoma in a young girl causing expansion of bone and facial asymmetry with the failure of eruption of. Odontomas are the most commonly occurring odontogenic tumors, which are considered by many to be hamartomas rather than neoplasms. They are seen with unerupted teeth in 1044% and about 17% of them. Compound odontoma in anterior case report mandiblea case report. There has not been a series study of the clinical and histologic features of odontomas from. Chapter 1 introducton histopathology definition it is a branch of pathology which deals with the study of disease in a tissue section. Odontomes are usually linked with an unerupted tooth.
Complex odontoma it is composed of haphazardly arranged dental hard and soft tissue. Large complex odontoma europe pmc article europe pmc. An 8yearold girl presented to her dentist for a routine dental examination. Odontoma complex and compound difference and pictures dr. Ramasamy, 2 andsrinivasaprasad 3 department of oral and maxillofacial pathology, sri venkateswara dental college and hospital,al ambur, chennai, india. Here, we report a case of compound odontome in 6 year old male patient. Odontogenic cysts, tumors, and related jaw lesions ento key. Radiologic and pathologic characteristics of benign and. An odontoma, also known as an odontome, is a benign tumour linked to tooth development. Due to their hamartomatous nature, they are usually asymptomatic but can cause impaction of one or more teeth. Some of the pictures of complex odontoma picture of complex odontoma graphic diagnosis. Complex odontoma definition of complex odontoma by.
Histopathology although reduced enamel epithelium may be present, odontomas are essentially composed of enamel, dentin, cementum, and pulp tissue. Compound odontoma and unerupted a dentigerous cyst containing an ectopic canine tooth below the floor of the maxillary sinus. They are usually asymptomatic but sometimes can be. We present a case of a large complex odontoma with mandibular 3 rd molar and missing 1 st and 2 nd mandibular molars. However, a large complex odontoma such as the one in the present case, measuring 4. According to 1992 who classification of odontogenic tumours, there are four odontogenic tumours with mixed tissue, that is, ameloblastic fibroma, complex odontoma, compound odontoma and ameloblastic fibro odontoma. Odontomas were classified histopathologically as complex, compound, or mixed and divided into 10 groups according to clinical diagnosis. On the edges there may be a thin layer of cementum which forms a capsule. Odontoma tumor types, diagnosis, histology, treatment. Compound odontomas show a predilection for the anterior maxilla, while complex odontomas are typically found in the posterior mandibular region as seen in the present case. Dental rehabilitation of patient with complex odontoma. Ramasamy, 2 and srinivasa prasad 3 1 department of oral and maxillofacial pathology, sri venkateswara dental college and hospital, thalambur, chennai 603103, india.