TRATAMENTO E ANÁLISE HISTOPATOLÓGICA DE ODONTOMA COMPLEXO: RELATO DE CASO

Odontoma is a benign calcifying odontogenic tumor of unknown etiology, although local trauma, genetic factors, and chronic inflammation may be related. They are classified into compound and complex types, depending on the morphological, radiographic and histological characteristics. Clinically they hardly show signs or symptoms, and, when present, are related to delayed tooth eruption, cortical bone expansion and tooth displacement. Although radiographic exams are complementary, most cases of odontomas reported in the literature are found on routine radiographs. The diagnostic hypothesis is confirmed by histopathological examination that shows evidence of the presence of enamel, dentin, cementum and pulp tissue arranged in the form of denticles (compound) or a disorganized mass (complex). The treatment consists of surgical excision of the lesion. The aim of this article was to report a clinical case and histopathological analysis of a complex odontoma associated with an unerupted tooth, located on the left side in the posterior region of the maxilla, discovered by routine radiographic examination of a 57-year-old male patient. The treatment was surgical excision of the lesion, removal of the unerupted tooth and histopathological examination, which confirmed the diagnosis of complex odontoma. The case was followed-up clinically and radiographically for one year and showed no recurrence.

Odontome- Revisted

Odontomas are benign odontogenic tumors subdivided morphologically into complex or compound odontomas. This paper describes the case of a complex odontoma in a 31-year-old male who complained of a painless swelling in right mandibular region which was diagnosed radiographically as complex odontome. Surgical enucleation of the lesion was done and sent for histopathological examination.

Odontomas and imaging diagnosis: the concise systematic review

Introduction: Odontomas are tumors of odontogenic origin. They represent on average 70% of all odontogenic tumors found. Early diagnosis and treatment prevent the loss of tissue element, tooth impaction, bone malformations, and displacement of bone structures, differentiating their types through panoramic radiographic images. Objective: To carry out a concise systematic review of the characteristics of odontomas, differentiating their types through panoramic radiographic images. Methods: The research was carried out from May 2021 to June 2021 and developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar, following the Systematic Review-PRISMA rules. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: A total of 84 articles were found. A total of 36 articles were evaluated in full and 17 were included and evaluated in the present study. A total of 3 Studies with a High Risk of Bias and 1 Study with Uncertain Risk. Radiographic examination is extremely important for the study and diagnosis of odontomas. Odontomas present a characteristic radiographic appearance. In complex odontomas, radiopacity is not specifically determined, showing itself as an irregular and disorganized mass surrounded by a narrow radiolucent zone. In the composite type, the radiographic image is pathognomonic. In the radiopaque image, dozens of denticles simulate small teeth surrounded by a thin radiolucent area. Composite odontoma, on the other hand, consists of the same calcified structures arranged in an orderly and related manner, similar to normal teeth contained in a fibrous capsule. The differential diagnosis of complex odontoma includes osteomas and condensing osteitis. Conclusion: Radiographic and/or tomographic examination is the best way to obtain an accurate diagnosis, precisely delimiting the lesion and nearby and involved structures.

Intra-sinus complex odontoma management simultaneously to oroantral communication closure: Why remove it?

The oroantral communication is considered one of the most frequent complications in oral surgery, especially in extractions of posterior teeth in the maxilla, treatment of cystic lesions, neoplasms, osteomyelitis and trauma in the region of the maxillary sinus, forming fistulas. However, ectopic third molar and lesions such as odontomas are rarely found simultaneously in the maxillary sinus. This report shows a successful treatment performed in a specific case of oroantral communication, associated to an underdiagnosed complex odontoma and an impacted ectopic third molar into the maxillary sinus and discuss the requirement of intervention. The treatment strategy involved clinical and surgical management through the oroantral communication, avoiding additional bone access to the maxillary sinus. This proposal presented a satisfactory result, and at six months after surgery, the patient has an excellent evolution, proving to be a successful strategy.

Erupting Compound Odontome - A Case Report

Odontomas are asymptomatic, benign odontogenic tumours comprised of dental tissue. Most of the cases usually get detected on routine radiographic evaluation. Odontoma can be classified according to morphology in two different variants, compound odontoma showing anatomic similarity or miniature version of the tooth and complex odontoma having irregular masses with different type of dental tissues. Early detection of such type of silent lesion is mandatory to rule out certain silent but aggressive pathologies. Here, we present a case of erupting compound odontoma of maxillary area in 15-year-old male patient. Development of tooth is a result of complicated interaction between ectodermal and ecto mesenchymal tissue. Sometimes the remnants of such tissues are left behind in the jaw after development and eruption of tooth, which can become a source of development of odontogenic lesions later on.1 As revealed by World Health Organization (WHO), Odontogenic tumours can be classified in three different categories according to their histopathological form.2 1. Odontogenic tumours which develop from odontogenic epithelium without involvement of odontogenic ectomesenchyme, 2. Odontogenic tumours which develop from odontogenic epithelium with involvement of odontogenic ectomesenchyme, with or without formation of dental hard tissue and 3. Odontogenic tumours which develop from odontogenic ectomesenchyme with or without involvement of odontogenic epithelium.2 For such lesions “Odontoma” word was initially given by Paul Broca in 1866, who revealed the term as tumour occurred by the overgrowth of entire dental tissue. The growth of absolutely differentiated epithelial cells as functional ameloblast and mesenchymal cells as functional odontoblast can give rise to a different developmental anomaly coined as Odontomas.3 According to their behaviour and composition, odontomas can be considered as malformations or hamartomas rather than a true neoplasm. 4,5,6 In 2005, World Health Organization (WHO) classified two variants of odontomas, 1. Compound odontomas, which typically appears as unilocular lesions containing multiple radiopaque, tiny tooth like structures commonly known as denticles; and 2. Complex odontomas, which is comprised of an irregular mass of soft and hard dental tissues.

Complex Odontoma: A Case Report

Odontoma, a mixed odontogenic tumor, is considered to be a hamartoma rather than a true neoplasm. Fully developed odontomas chiefly consist of enamel, dentin, pulp and occasionally cementum. They are subdivided into compound and complex types. The compound odontoma is composed of multiple, small tooth like structures, whereas the complex type consists of a conglomerated mass of enamel and dentin, having no anatomical resemblance to a tooth. They are usually asymptomatic, slow growing but cause bony expansion, which is often discovered during routine radiography. Here, we report a case of a complex odontoma in the posterior left mandibular region in an eight year old female child.