RESUMEN
This case report presents the enigma of multiple odontomes with overretained deciduous teeth leading to the impaction of permanent successors (22, 23) in an abnormal position in a 17-year-old female patient who reported the chief complaint of maligned teeth. Permanent maxillary canines and lateral incisors are the most common teeth to face the brunt of impaction due to a wide range of etiological factors. It is imperative for a clinician to diagnose cases at an early stage to accelerate the rate of eruption of such teeth. This is especially important in cases where initially the etiology seems to be simple but on careful and judicious evaluation of the case, numerous other etiologies are found to map together for the underlying pathology. This case discusses how the presence of multiple odontomes with delayed exfoliation of deciduous teeth leads to the impaction of a permanent successor. Understanding the underlying pathology is seemingly important to devise intricate treatment mechanics for traction of impacted teeth without taxing anchorage from dental units and taking cognizance of the amount of alveolar bone loss post-removal of multiple odontomes. The appropriate thickness of alveolar bone scaffolding is required for the canine to extrude down, with an adequate band of marginal gingiva encircling the cement-enamel junction of the impacted canine, preventing any kind of fenestration and dehiscence. Hence, meticulous care was taken during surgical exposure and removal of odontomes to preserve an adequate labial cortical plate intact for traction. These excavated tooth-like structures were later subjected to histopathological evaluation, which confirmed the diagnosis of compound odontomes.
RESUMEN
Introduction: Odontomas are the most common odontogenic tumour. They are considered to be hamartomasrather than neoplasms. They are generally asymptomatic and are discovered on routine radiographicexamination. Odontomas might be associated with disturbance in tooth eruption. Other symptoms includeretention of deciduous teeth, pain, swelling, expansion of cortical bone, tooth displacement. Eruption ofodontoma in the oral cavity is rare with only 11 cases being reported about erupted compound odontomas.Case report: An unusual case of erupted compound odontome associated with pain and impacted maxillaryleft second premolar is reported. We have also discussed the clinical, radiographic and histopathologicfeatures of this rare condition.
Introdução: Odontomas são os mais comuns entre os tumores odontogênicos. Eles são considerados hamartomas,ao invés de neoplasias. Eles geralmente são assintomáticos e descobertos em exames radiográficos derotina. Odontomas podem estar associados com distúrbio na erupção dentária. Outros sintomas incluem retençãode dentes decíduos, dor, inchaço, expansão do osso cortical e deslocamento do dente. A erupção de um odontoma na cavidade oral é rara, com apenas 11 casos relatados de odontomas compostos erupcionados.Relato de caso: Um caso incomum de odontoma composto associado à dor e segundo pré-molar superior esquerdoimpactado é relatado neste artigo. Os aspectos clínicos, radiográficos e histopatológicos dessa doençarara também são discutidos.