Odontoma Associated with Over Retained Primary Teeth that Caused Ectopic Eruption of Canine: A Case Report

Case Report

Austin J Dent. 2016; 3(1): 1029.

Odontoma Associated with Over Retained Primary Teeth that Caused Ectopic Eruption of Canine: A Case Report

Jose D*

Department of Pedodontics, Kannur Dental College, India

*Corresponding author: Deepak Jose, Department of Pedodontics, Kannur Dental College, Anjarakandy, kannur, Kerala, India

Received: January 05, 2016; Accepted: April 04, 2016; Published: April 06, 2016


Odontomas are the most common type of odontogenic tumours and usually they are asymptomatic. However, odontomas are commonly causes ectopic position and/or impacted permanent teeth. There are few reports on odontomas which are associated with over retained deciduous tooth. Odontoma are commonly unerupted and surgical removal of odontoma is regular treatment of line. The purpose of the present case report is to describe a case of an odontoma which was associated with an over retained deciduous tooth. The over retained deciduous tooth was removed and the odontomas was surgically removed and over twenty seven denticles were obtained from the lesion.

Keywords: Odontoma; Ectopic canine; Primary teeth; Dental anomaly


Odontomas are developmental anomalies caused by the growth of completely differentiated epithelial and mesenchymal cells which give rise to ameloblasts and odontoblasts [1]. These are hamartomas rather than true neoplasms [2] and they may contain various dental tissues, i.e., enamel, dentin, cementum some times pulpal tissue [3]. Most of the odontomas are asymptomatic in nature and they are found during routine radiographic examination accidentally. They are the most common odontogenic tumour and among all odontogenis tumors, odontomas account for 50% [1]. Odontomas can be classified as complex and compound odontomas. Compound odontomas are commonly found in the maxillary anterior region and they are similar to normal teeth whereas compound odontomas are seen in posterior mandible followed by anterior maxillary region and they are mass like irregular structures. Radiographically compound odontomas are seen as a mass of multiple calcified structures which resemble normal teeth surrounded by a narrow radiolucent zone. Complex odontomas are more or less amorphous mass of calcified material which is also surrounded by a narrow radiolucent zone [3].

It has been suggested that trauma and infection at the place of the are common reasons for its appearance, however, the aetiology of odontomas are not clearly documented Odontomas are usually asymptomatic, and they may be detected by chance on a routine radiograph (panoramic and/or intra-oral X-rays), or when they are large enough to cause a swelling of the jaw. Retained deciduous tooth or an impacted tooth, are clinical signs suggestive of an odontoma. The treatment of these lesions includes surgical removal followed by orthodontic correction if needed and follow up [4]. Odontomas could be diagnosed at any age and mostly commonly found in first two decades of life. Though diagnosis can be confirmed by radiographs, it is recommended to carry out a histological examination to confirm the diagnosis [5]. The purpose of the present case is to report a case of a compound odontoma with twenty seven denticles caused over retained of deciduous teeth and ectopic position of maxillary canine.

Case Presentation

A 14 year old male patient presented to the Department of Pedodontics and preventive dentistry with a chief complaint of irregularly aligned maxillary anterior teeth. Upon examination, the primary maxillary right lateral incisor was over retained, the permanent maxillary right lateral incisor had erupted distal to it and buccaly erupted canine were observed (Figure 1). An intra-oral periapical radiograph revealed the presence of compound odontome in relation to the deciduous lateral incisor perioapically. A maxillary anterior occlusal radiograph and a panoramic radiograph (Kuer’s Technique or Verticle tube shift technique) were taken for further to locate the odontome (Figure 2 a and b). Based on clinical and radiographic examinations the diagnosis of compound odontome was confirmed. Parents and patient were informed regarding the presence of the odontome. The options that were included that extraction of lateral incisor, surgical removal of odontome and fixed orthodontic treatment for the alignment of the teeth in maxillary arch. The deciduous lateral incisor and surgery removal of odontoma were performed under local anesthesia. The mineralized structures showing a tooth-like appearance were found within the lesion (Figure 3). Overall Twenty seven denticles were removed from the surgical site. The patient was referred to the department of Orthodontics for further evaluation and treatment.