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