Odontomas are developmental tumors that arise from the dental tissue. They are benign and can be classified into compound and complex. Usually, they occur at a young age and are asymptomatic.
Odontomas are hamartomas that most frequently occur in children and young people, with a higher incidence in the second decade of life. They are not, however, limited to this age group. Odontomas in themselves are rare tumors, with cases comprising only 0.1% of the general population, but make up a large proportion of odontogenic tumors . In fact, they are the most common masses of odontogenic origin to occur in the oral cavity.
They consist of dental tissue that is both mesenchymal and epithelial in origin and may contain any of components of teeth, that is, pulp, dentin, enamel or cementum. It is unclear in the literature whether the tumors have a male or female predilection, however, some authors claim that odontomas have a marginal female preponderance .
Odontomas are usually small and asymptomatic, although generally, they can disrupt the eruption of neighboring teeth. Symptomatic odontomas typically present with displaced teeth, pain, swelling and a disruption of the bony architecture of the jaw . The latter is especially common with odontomas that present as a large mass, prone to complications such as bone expansion and impaction  . Patients may have other dental problems simultaneously.
Odontomas are often classified into two types: compound and complex. They can occur both in the maxilla or mandible, although the former is the more common location  . Compound odontomas are small, organized structures that resemble a cluster of teeth . They tend to occur in the anterior part of the maxilla. In contrast, complex odontomas are poorly differentiated structures that contain cementum, dentin, and enamel. These tend to develop in the posterior maxilla. Odontomas can occasionally occur in soft tissue (gums) .
There are a number of risk factors for the development of odontomas, and these include trauma, infections, inherited conditions like Gardner and Hermann's syndromes, genetic mutations, and the abnormal proliferation of a type of neural crest cells (odontoblasts) that are found in the pulp .
Entire Body System
[…] cystic odontogenic tumor (CCOT) Multiple odontomas may occur as a component of: Gardner syndrome (familial colorectal polyposis) Otodental syndrome Multiple supernumerary teeth (similar radiographic appearance) can occur as a component of cleidocranial dysostosis [pathologyoutlines.com]
A review of English literature showed 12 cases of multiple compound odontomas excluding this report; such cases are at times associated with Cleido cranial dysostosis or Gardner’s syndrome (GS). [file.scirp.org]
- Recurrent Sinusitis
We describe the case of a 76-year-old man who presented with symptoms of chronic nasal obstruction and recurrent sinusitis of many years' duration. [ncbi.nlm.nih.gov]
- Soft Tissue Mass
Upon extraction, an irregular hard tissue mass was seen attached to the labial side (1.3 × 0.08 × 0.7 cm) and a soft tissue was enveloping mesial and lingual side of the root of extracted tooth. [indjos.com]
Jaw & Teeth
There are two standard methods of diagnosis of odontomas, and these include radiographic imaging, as well as histological analysis of the sample tissue. Often, odontomas are discovered incidentally, during routine radiographs  .
Typical radiographic features are dependent on the type and stage of a particular tumor. Initially, tumors may be radiolucent, with the inclusion of small calcifications. They progress to being entirely radiodense, with a persisting radiolucent rim. Compound odontomas may show denticles, which appear in different shapes and sizes and resemble teeth, within a well-demarcated, septate, radiolucent mass .
Complex odontomas have no recognizable structures and are a mixture of dense material within a lucent margin  . Dentigerous cysts may also be visualized, although their occurrence is rare.
The treatment was considered a success, since both health and aesthetics of the smile were recovered. [ncbi.nlm.nih.gov]
The diagnosis, complications, treatment, and prognosis of this entity will be discussed. [ncbi.nlm.nih.gov]
The etiology of odontoma is unknown, although several theories have been proposed. This article describes a case of a large infected complex odontoma in the residual mandibular ridge, resulting in considerable mandibular expansion. [ncbi.nlm.nih.gov]
However, etiology of formation of odontoma is still elusive. [casereports.in]
Persistence of a portion of dental lamina may be an important factor in the etiology of a compound odontoma.  Most odontomas are asymptomatic; occasionally, however, signs and symptoms relating to their presence do occur. [jomfp.in]
Epidemiology [ edit ] Odontomas are thought to be the second most frequent type of odontogenic tumor worldwide (after ameloblastoma ), accounting for about 20% of all cases within this relatively uncommon tumor category which shows large geographic variations [en.wikipedia.org]
A clinical histological and retrospective epidemiological study of 46 cases. Med Oral 2000; 5: 367-72. - 26 Budnick SD. Compound and complex odontomas. [benthamopen.com]
A clinical–histological and retrospective epidemiological study of 46 cases. Med Oral, 5 (2000), pp. 367-372  M. Hisatomi, J. Asaumi, H. Konouchi, Y. Honda, T. Wakasa, K. Kishi. [elsevier.pt]
[…] ameloblastic fibro-odontomas as developing odontomas rather than a distinct tumor ( IARC: WHO Classification of Head and Neck Tumours, 4th Edition, 2017 ) Terminology Compound odontoma Complex odontoma Ameloblastic fibro-odontoma Peripheral odontoma Epidemiology [pathologyoutlines.com]
Each entity is extensively discussed with information on clinicopathological, epidemiological, immunophenotypic and genetic aspects of these diseases. This book is in the series commonly referred to as the "Blue Book" series. Contributors: :Dr. [books.google.com]
[…] common odontogenic tumor Usually diagnosed during the first two decades of life No sex predilection Sites Can occur in any tooth bearing area Compound odontoma usually occurs in anterior maxilla Complex odontoma usually occurs in posterior mandible Pathophysiology [pathologyoutlines.com]
The purpose of this study is to report the case of a complex odontoma in a child impacting a permanent molar and preventing its eruption. [ncbi.nlm.nih.gov]
Madhuri Vegesna *, Chandrasekhar R and Vinay C Department of Pedodontics and Preventive dentistry, Vishnu Dental College, Bhimavaram, AP, India *Corresponding Author: Madhuri V Department of Pedodontics and Preventive Dentistry Vishnu Dental College, [omicsonline.org]
Other : Commonly prevents normal eruption of permanent teeth. Number : Single. Multiple is rare but possible. (Click image to enlarge) Periapical radiographs – note the multiple well-defined tooth-like structures in the left anterior mandible. [drgstoothpix.com]
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