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
Odontomas are the most common type of odontogenic tumor and are generally asymptomatic. [ncbi.nlm.nih.gov]
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. [symptoma.com]
Open surgical procedures can also potentially cause impaction and developmental disturbances. [ncbi.nlm.nih.gov]
Figure 2: Orthopantomogram showing irregular ill-defined calcified masses in the lower anterior region Click here to view Surgical procedure Surgical removal of the odontoma under the local anesthesia was planned. [jomfp.in]
Since the child exhibited frankle’s definitely negative behaviour the surgical procedure was done under general anesthesia. Buccal mucoperiosteal flap was elevated and the bone overlying the lesion was removed. [omicsonline.org]
Figure 3: Surgical Procedure. Figure 4: Progress of orthodontic treatment. Figure 5: Post-treatment results. [medcraveonline.com]
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]
Aspiration performed during surgery was negative for blood and other exudates. No recurrence has occurred during a follow-up period of 11 months. [ncbi.nlm.nih.gov]
The rigorous review process does not allow any compromise in quality It is indexed in many indexing agencies and the articles are available under creative commons licence free of cost The frequency of publication supports many aspiring authors from India [doi.org]
Fine needle aspiration cytology of the lesion was performed, which yielded straw colored fluid and a provisional diagnosis of dentigerous cyst was made. [mjdrdypu.org]
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]
Therefore, the treatment and prognosis differs for these two histologically similar neoplasms. [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]
The exact etiology of odontomes is still not known. Most odontomes are asymptomatic and are discovered during routine radiographic investigations. [jisppd.com]
However, etiology of formation of odontoma is still elusive. [casereports.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, 5 (2000), pp. 367-372  M. Hisatomi, J. Asaumi, H. Konouchi, Y. Honda, T. Wakasa, K. Kishi. [elsevier.pt]
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.ro]
[…] 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]
[…] 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]
- Yeung KH, Cheung RC, Tsang MM. Compound odontoma associated with an unerupted and dilacerated maxillary primary central incisor in a young patient. Int J Paediatr Dent. 2003;13(3):208-212.
- Nelson LB, Thompson DRL. Compound odontoma. Head Neck Pathol. 2010;4(4):290-291.
- Soluk Tekkesin M, Pehlivan S, Olgac V, Aksakallı N, Alatli C. Clinical and histopathological investigation of odontomas: review of the literature and presentation of 160 cases. J Oral Maxillofac Surg. 2012;70(6):1358-1361.
- Serra-Serra G, Berini-Aytés L, Gay-Escoda C. Erupted odontomas: a report of three cases and review of the literature. Med Oral Patol Oral Cir Bucal. 2009;14(6):E299-303.
- Vengal M, Arora H, Ghosh S. Large erupting complex odontoma: a case report. J Can Dent Assoc. 2007;73(2):169-173.
- Oz YG, Tosun G, Kiziloğlu D, Durmuş E, Şener Y. An unusual association of odontomas with primary teeth. Eur J Dent. 2007;1(1): 45–49.
- Junquera L, de Vincente JC, Roig P, Olay S, Rodriguez-Recio O. Intraosseous odontoma erupted into the oral cavity: an unusual pathology. Med Oral Patol Oral Cir Bucal. 2005;10(3):248-251.
- Otsuka Y, Mitomi T, Tomizawa M, Noda T. A review of clinical features in 13 cases of impacted primary teeth. Int J Paediatr Dent. 2001;11(1):57-63.
- Amado CS, Gargallo AJ, Berini AL, Gay EC. Review of 61 cases of odontoma. Presentation of an erupted complex odontoma. Med Oral. 2003;8(5):366–373.
- An SY, An CH, Choi KS. Odontoma: a retrospective study of 73 cases. Imaging Sci Dent. 2012;42(2):77–81.