Odontoma malformation and disturbances of eruption subsequent to traumatic dental injuries: A literature review and a case report.

Due to the close proximity of the primary teeth with the developing permanent successors, several developmental alterations in the permanent successors have been reported as consequences of traumatic dental injuries to the primary dentition. When they occur at a very young age such trauma could disturb normal tooth development and cause rare anomalies, including sequestration of the permanent tooth germ and odontoma-like malformations. A literature review of case reports with a history of trauma and odontoma formation is discussed in this paper. This paper also includes a case report of a patient, who was 3-years and 5-months old, when she was seen at the University of California, Los Angeles Children's Dental Center for the first time. The grandmother reported that the child was dropped from the father's lap when she was 2 weeks old and suffered head trauma and multiple skull fractures.

Dentinogenic Ghost Cell Tumor associated with Odontoma: A unique Histopathological Entity and its Surgical Management.

We report a rare case of dentinogenic ghost cell tumor (DGCT) associated with complex composite odontoma in a 17 years male affecting the posterior segment of the mandible. On radiographic examination, there was a well-defined multilocular radiolucency surrounding the radio opaque mass with respect to 44, 45 and 46. Histopathologically it showed ameloblastomatous proliferation with dentin like areas and ghost cells. It was associated with tooth like structures consisting of dentin, cementum and pulp like areas. DGCT with odontoma is extremely rare with only two cases being reported in literature till date. The management with its rare occurrence is discussed here.

Delayed Eruption of Permanent Lower Lateral Incisor in Relation to Compound Odontoma: A Case Report.

AIM: To report a delayed tooth eruption following late surgical removal of a compound odontoma in a 10-year-old child. BACKGROUND: Odontomas are the most common odontogenic tumors. They are usually asymptomatic and discovered during routine radiographic examinations or during an assessment of delayed tooth eruption. Odontomas are classified into compound or complex based on the microscopic structure of dental tissues. Early diagnosis and surgical removal of odontomas is the keyword for favorable results. CASE DESCRIPTION: This paper describes a case of compound odontomas in a 10-year-old boy that prevented eruption of the permanent mandibular lateral incisor. Extraction of mandibular primary lateral incisors and surgical excision of the compound odontomas was performed. After 3 years of follow-up, at the age of 13 years, the permanent lateral incisor erupted and approached the occlusal plane. CONCLUSION: Late surgical removal of odontomas resulted in a delayed eruption of the affected teeth. CLINICAL SIGNIFICANCE: Surgical removal of odontomas and regular follow-up to monitor the eruption of the affected teeth should be considered for the teeth with an open apex before considering orthodontic traction.

Odontoma associated with mandibular transmigrated canine in a geriatric patient: Second case report.

OBJECTIVE: This report discusses the clinical relevance of a novel case of an odontoma and transmigrated canine in the setting of florid cemento-osseous dysplasia (COD), hypercementosis and moderate to severe periodontitis in a 66-year-old patient. BACKGROUND: An odontoma may infrequently impede tooth eruption and rarely has been implicated with canine transmigration. COD is a benign fibro-osseous lesion associated with decreased vascularity and poorer surgical intervention. MATERIALS AND METHODS: A partially edentulous woman, in no acute distress, underwent clinical and radiographic evaluation in pursuit of comprehensive dental care. RESULTS: Radiographic assessment demonstrated multiple occult pathologies of the mandible, including compound odontoma, canine transmigration, florid COD, hypercementosis and moderate to severe periodontitis, a concurrence thought to be previously unreported. Furthermore, the presence of the odontoma and transmigrated canine is apparently the second reported case in the geriatric population. CONCLUSIONS: The attending clinician should carefully weigh removal of an impacted and transmigrated canine associated with an odontoma in the setting of COD and compromised bone, particularly in older individuals. When surgical intervention is deferred in these clinical situations, patients should continue to be monitored for clinical and radiographic development of pathologic processes.

Evaluation of dentofacial asymmetry caused by odontomas using panoramic radiographs.

AIMS: To evaluate the presence of dentofacial asymmetry in patients with odontoma by panoramic radiography. METHODS: Panoramic images with odontoma were selected among all panoramic radiographs (3058 patients). Maxillary odontoma was detected in 27 patients while mandibular odontoma was detected in 25 patients. In addition, 30 patients with similar age and gender characteristics were selected as the control group. Skeletal angular, skeletal linear and dental measurements were performed on panoramic radiographs. The odontoma region and the opposite side of the odontoma of the individuals were examined. The dentofacial asymmetry of the odontoma groups was compared with the control group. Paired t-test was used to determine dentofacial asymmetry on the right and left side of the patients with odontoma. The ANOVA test was used for testing the differences among groups. RESULTS: As a result of study, no significant difference was found between the region of the odontoma and the symmetrical region in the maxilla and mandibula (P > 0.05). In the control group, a statistically significant difference was found in the angle between the mandibular canal and the mental foramen, lower incisor size, PFH/CutCat(°), and Co-Mc-Me(°) measurements (P < 0.05). In the maxillary and mandibular odontoma groups, a statistically significant difference was found in the angle between the mandibular canal and the menton, CH (mm), RH (mm), and CrH (mm) in the comparison of the odontoma and the control group (P < 0.05). CONCLUSIONS: No difference was found between the right and left sides of the jaws related with the asymmetry of the maxilla and mandible.

Autotransplantation of Odontoma-Associated Impacted Teeth-A Treatment Strategy for Satisfying Immediate Esthetic Demands: A Case Report.

Compound odontomas are common odontogenic tumors associated with permanent tooth impaction in the premaxilla. This report describes the case of a 14-year-old girl with an odontoma-associated impaction over the premaxilla that was treated using autotransplantation to satisfy an immediate esthetic demand. At postoperative follow-up conducted in the 14th month, a satisfactory cosmetic appearance with a healthy periodontal status was observed. In addition, the authors discuss the possible complications of autotransplantation and different treatment strategies for odontoma-associated impaction and for correcting bone defects in this case report. Autotransplantation for treating odontoma-associated impaction can be an alternative solution for satisfying an immediate cosmetic demand and providing a favorable outcome.

Ameloblastic Fibro-Odontoma of the Maxilla in a Pierre-Robin Sequence Patient.

INTRODUCTION: Pierre Robin sequence (PRS) is a rare disorder classically observed as a triad of features including micrognathia, glossoptosis, and upper airway obstruction. It is associated with a syndrome in about 60% of cases. While odontogenic tumors are common findings in patients with familial adenomatous polyposis and nevoid basal cell carcinoma syndromes, PRS has not been found to be consistently associated with any tumors of the jaw. CASE REPORT: The current report aims to describe a patient with PRS who presented with an extensive ameloblastic fibro-odontoma (AFO) of the maxilla. CONCLUSION: Continued observation for odontogenic tumors in PRS is necessary.

Clinical parameter of odontoma with special emphasis on treatment of impacted teeth-a retrospective multicentre study and literature review.

OBJECTIVES: Odontoma-separated into complex (CxOD) and compound (CpOD) subtypes-represents the most frequent odontogenic malformation. Retention of permanent teeth is a common symptom. Therefore, in a series of odontomas, an analysis of the management of retained teeth was conducted. MATERIALS AND METHODS: In a retrospective multicenter study of two University Medical Centers and one private praxis in Germany, demographic and clinical data regarding odontomas from 01/2000-03/2015 were obtained. In particular, the influence of operative therapy on the dentition and on the treatment of impacted teeth was analyzed. RESULTS: Forty-five patients with 15 CxOD and 30 CpOD were included. Initial symptoms were delayed eruption of permanent teeth (n = 11), pain (n = 4), and swellings (n = 2); 28 cases were discovered by incidence, all of them via panoramic radiographs. The mandible/maxilla ratio was about 1:0.55 (29/16). Thirty-five out of 45 odontomas were in close proximity of at least one tooth (n = 16 at molars). A total of 14 teeth were extracted (CxOD: n = 5; CpOD: n = 9). Extractions had to be conducted more often in older patients (mean age 39.8 vs. 25.6 years). Of the non-extracted teeth, 8 teeth were displaced and retained. Of those, 4 teeth were aligned in the dental arch via orthodontic help and 2 teeth erupted spontaneously after operation during the follow-up period. In all cases, no relapse was seen. CONCLUSION: Odontomas can cause displacement as well as malformation and resorption of the adjacent teeth. CLINICAL RELEVANCE: Mostly, removal of odontomas is conducted. Extirpation of odontoma can allow for normal tooth eruption, often rendering extractions avoidable. Orthodontic alignment, though sometimes challenging, is a reasonable therapeutic option. These findings underline the value of the panoramic radiograph in preventive dentistry in younger patients.

Complex and compound odontomas: Analysis of 69 cases and a rare case of erupted compound odontoma.

OBJECTIVE: The purpose of this study was to analyze clinic and radiologic features of the 69 odontoma cases and present a rare case of erupted compound odontoma in the oral cavity. MATERIAL AND METHODS: The 69 cases were analyzed with regard to the following parameters: age, gender, location, associated unerupted teeth, missing teeth, radiological and histopathological features and treatment protocols. RESULTS: Of the 69 cases, 49 were compound odontoma and 20 were complex odontoma. There was a female predilection for both compound and complex odontomas. Compound odontoma occurred more often in the anterior region of the jaws; complex lesions occurred more often at the posterior mandible. The most common clinical manifestations were the retention of permanent teeth. CONCLUSION: Compound odontomas rarely erupt into the mouth. The presented case is the 13 th case of erupted compound odontoma reported in the literature. The treatment of choice is surgical removal of the odontoma. In the case of odontomas associated to impacted teeth, the teeth should be preserved in wait of spontaneous eruption, or alternatively fenestration followed by orthodontic traction is indicated. Regular follow-up period is crucial to evaluate the prognosis of these teeth.

Midline diastema and its aetiology--a review.

Maxillary midline diastema is a common aesthetic complaint of patients. Treating the midline diastema is a matter of concern for practitioners, as many different aetiologies are reported to be associated with it. The appearance of midline diastema as part of the normal dental development makes it difficult for practitioners to decide whether to intervene or not at an early stage. The aim of this article is to review the possible aetiology and management options which will help the clinician to diagnose, intercept and to take effective action to correct the midline diastema. The available data shows that an early intervention is desirable in cases with large diastemas. Treatment modality, timing and retention protocol depends on the aetiology of the diastema. Therefore, priority needs to be given to diagnosing the aetiology before making any treatment decisions. Clinical Relevance: This article aims to determine and evaluate the aetiology and possible treatment options of midline diastema.

A novel APC mutation associated with Gardner syndrome in a Chinese family.

Gardner syndrome (GS) is a specific form of familial adenomatous polyposis (FAP), which manifests as colorectal polyps, multiple osteomas and soft tissue tumors, and in the oral cavity as osteomas of the jaws, odontomas, and abnormal tooth counts. The underlying cause of GS is attributed to mutations in the APC gene. Mutations in this gene disrupt the normal functioning of the protein and lead to the development of GS. To further investigate GS, a family affected by the syndrome was selected from Dongguan, Guangdong Province. The family members underwent a comprehensive survey, which involved collecting clinical data and peripheral venous blood samples. The samples were then used for genetic analysis. Whole exome sequencing (WES) and Sanger sequencing techniques were utilized to screen and identify specific mutation sites in the APC gene. The clinical findings for the GS family included the presence of gastrointestinal polyps and odontomas. After analyzing the genetic sequencing results, a novel mutation site c.4266dupA on the APC gene was found in the patients, which leading to the APC protein truncation. As a result of this study, it is suggested that odontoma may be an early indicator of GS. Additionally, the identification of this novel mutation site in the APC gene expands the known spectrum of genetic mutations associated with the disease. This discovery has significant implications for the early diagnosis of GS, thus enabling timely intervention to reduce the risk of developing colon cancer and other related diseases.

Impeded eruption of mandibular canine.

Odontome, tumor of odontogenic origin, is associated with disturbances in the eruption of teeth such as impaction, delayed eruption or retention of permanent teeth. It is seen on radiographic examination as a radiopaque lesion which may be single or multiple. Morphologically, odontomes are of two types-compound or complex and can be found at any age with high prevalence in maxilla than in mandible. In this case report, lack of eruption of permanent mandibular canine owing to presence of associated compound odontome is presented.

Erupted complex odontoma delayed eruption of permanent molar.

Odontomas, benign tumors that develop in the jaw, rarely erupt into the oral cavity. We report an erupted odontoma which delayed eruption of the first molar. The patient was a 10-year-old Japanese girl who came to our hospital due to delayed eruption of the right maxillary first molar. All the deciduous teeth had been shed. The second premolar on the right side had erupted, but not the first molar. Slight inflammation of the alveolar mucosa around the first molar had exposed a tooth-like, hard tissue. Panoramic radiography revealed a radiopaque mass indicating a lesion approximately 1 cm in diameter. The border of the image was clear, and part of the mass was situated close to the occlusal surface of the first molar. The root of the maxillary right first molar was only half-developed. A clinical diagnosis of odontoma was made. The odontoma was subsequently extracted, allowing the crown of the first molar to erupt almost 5 months later. The dental germ of the permanent tooth had been displaced by the odontoma. However, after the odontoma had been extracted, the permanent tooth was still able to erupt spontaneously, as eruptive force still remained. When the eruption of a tooth is significantly delayed, we believe that it is necessary to examine the area radiographically. If there is any radiographic evidence of a physical obstruction that might delay eruption, that obstruction should be removed before any problems can arise. Regular dental checkups at schools might improve our ability to detect evidence of delayed eruption earlier.

Dentinogenic ghost cell tumor associated with odontoma: report of a rare case and review of literature.

Dentinogenic ghost cell tumor (DGCT) is an uncommon odontogenic tumor considered to be the solid, tumorous variant of calcifying odontogenic cyst. DGCT is characterized by islands of ameloblastoma-like epithelial cells that resemble the enamel organ, the presence of ghost cells, and dentinoid material. This article reports a rare case of dentinogenic ghost cell tumor associated with an odontoma in an adult patient, with a review of the literature. To the best of the authors' knowledge, there have only been four case reports of DGCT associated with odontoma, all of which occurred in children and adults younger than 30 years old.

Odontoma-associated tooth impaction: accurate diagnosis with simple methods? Case report and literature review.

Odontomas account for the largest fraction of odontogenic tumors and are frequent causes of tooth impaction. A case of a 13-year-old female patient with an odontoma-associated impaction of a mandibular molar is presented with a review of the literature. Preoperative planning involved simple and convenient methods such as clinical examination and panoramic radiography, which led to a diagnosis of complex odontoma and warranted surgical removal. The clinical diagnosis was confirmed histologically. Multidisciplinary consultation may enable the clinician to find the accurate diagnosis and appropriate therapy based on the clinical and radiographic appearance. Modern radiologic methods such as cone-beam computed tomography or computed tomography should be applied only for special cases, to decrease radiation.

Management of compound odontoma in a 10-year-old girl preserving the associated impacted permanent tooth.

AIM: Compound odontoma has been reported to be the most common of all odontogenic neoplasms and tumor- like lesions. Only rarely the treatment of this lesion in association with an impacted tooth has been reported. CASE REPORT: A compound odontoma in a 10-year-old girl, associated with an impacted permanent incisor is described, focusing on the diagnosis and the importance of early treatment of this lesion. The patient underwent surgical excision of the lesion and it was decided to wait for the spontaneous eruption of the impacted tooth. After 6 months no eruption was observed and thus the orthodontic treatment was deemed necessary. At the one-year follow-up, the tooth was brought into the maxillary arch.

Treatment protocol for the impaction of deciduous maxillary anterior teeth due to compound odontoma.

AIM: The purpose of this paper was to describe the dental and surgical management of the impaction of deciduous maxillary anterior teeth due to compound odontoma. In all analysed patients impaction of the maxillary deciduous canine was associated with the presence of an odontoma. Therefore, impaction of the maxillary deciduous canine can be considered as pathognomonic of the presence of an intraosseous odontoma. The analysis of the described cases showed that early diagnosis and early removal of the odontoma are essential in improving the prognosis of the involved teeth. Early treatment allows the impacted tooth to re-start the physiological eruption. A conservative surgical approach is advisable in order to minimise damage to the impacted teeth and preserve their normal timing and path of eruption.

[Prevention of the eruption of an upper later incisor by a compound odontoma. Case report]. / Durchbruchsbehinderung eines lateralen Inzisiven im Oberkiefer aufgrund eines zusammengesetzten Odontoms. Ein Fallbericht.

Odontomas are the most common odontogenic tumours. They are considered as hamartomas - a local tissue malformation without autonomous growth potential - and are non-neoplastic. Clinically and histopathologically, compound and complex odontomas can be differentiated. Compound odontomas consist of a varying number of tooth-like structures and histology show dental tissues in an orderly pattern. Most often compound odontomas are diagnosed in young patients in the anterior maxilla. Patients are rarely complaining of symptoms and they are usually diagnosed during routine radiographic examinations or due to late eruption of permanent or persistence of deciduous teeth. The following case report presents a disturbed eruption of a lateral right incisor of the maxilla in a 8-year old female patient. Clinical, radiological and histopathological characteristics of this lesion will be discussed as well as therapy and follow-up.

Ameloblastic Fibro-Odontoma in a Free-Ranging Rocky Mountain Bighorn Sheep (Ovis canadensis canadensis), Alberta, Canada.

An adult female Rocky Mountain bighorn sheep (Ovis canadensis canadensis) was euthanized because of a large mandibular mass. Histopathology revealed an ameloblastic fibro-odontoma, a rare odontogenic neoplasia.