Compound Odontoma in Maxillary Anterior Region: A Case Report

Case Report

Austin J Dent. 2018; 5(4): 1113.

Compound Odontoma in Maxillary Anterior Region: A Case Report

Ramya Rai, Rajashekar Reddy V*, Prashant Babaji and Shashibushan KK

Department of Pedodontics and Preventive Dentistry, Sharavathi Dental College and Hospital, India

*Corresponding author: Rajashekar Reddy V, Department of Pedodontics and Preventive Dentistry, Sharavathi Dental College and Hospital, Shimoga, Karnataka, India

Received: February 01, 2018; Accepted: March 21, 2018; Published: April 13, 2018


Odontomas are most common hamartomatous developmental malformations. They can be differentiated into compound and complex type based on the level of organization of the tissues. Majority of odontomas are asymptomatic however these lesions can cause delayed eruption, impaction, or even retention of deciduous teeth. This case report presents a compound odontoma in 13 year old boy along with its related clinical and radiological manifestations and the surgical management.

Keywords: Odontoma; Impacted teeth; Maxilla


Odontomas are mixed odontogenic tumors in which both the epithelial and mesenchymal components have undergone functional differentiation to the point that both enamel and dentin are formed. The enamel and dentin are typically arranged in an abnormal pattern because the organization of the odontogenic cells fails to reach a normal state of morphodiffrentiation [1]. The most common of the odontogenic tumors, odontomas are thought about as hamartomatous rather than neoplastic in nature [2].

WHO has classified odontomas into two varieties depending on their degree of morphodifferentiation. Compound odontoma is a lesion within which all the dental tissues are depicted in an orderly fashion so that there is minimum of superficial anatomic alikeness to teeth. In a complex odontoma, on the other hand, although all the dental tissues are represented, they are formed in such a rudimentary fashion that there is little or no morphologic similarity to traditional tooth formation [3].

Odontoma may be discovered at any age in any location of the dental arch with no gender predilection. Compound odontomas have a propensity for prevalence in the canine and incisor region, being found more often in the maxilla than in the mandible, whereas complex odontomas show a predilection for occurrence in the posterior jaws [4]. Compound odontomas have been reported as having a mean age of occurrence of 14.8 years compared with 20.3 years of age for complex odontomas, possibly because the odontogenict issue in the anterior jaws where the compound odontoma predominantly occurs has finished its differentiation ahead than tissues in the posterior part of the jaw [5].

They believe that the compound odontoma represents a malformation with a high degree of histomorphologic differentiation similar to the process producing supernumerary teeth, “multiple schizodontia,” or locally conditioned hyper activity of the dental lamina [1].

The etiology of the odontoma is unknown, however trauma in primary dentition, Malassez paradental remnants, inflammatory processes, odontoblastic hyperactivity and hereditary anomalie [6]. It has been suggested by Hitchin that odontomas are either inherited or are due to a mutant gene or interferences, presumably postnatal, with the genetic control of tooth development [7].

Odontomas are most commonly found on routine radiographic examination, presenting as an irregular radiopaque mass or as small, tooth like structures with the fore most frequent presenting symptom being lack of eruption of a permanent tooth or bony expansion or swelling [1].

The recommended treatment for an odontoma is conservative surgical excision, with care taken to remove the surrounding soft tissue. No propensity for recurrence has been noted [8].

Case Presentation

A 13 year old, male patient reported with the chief complaint of unerupted upper front tooth. His medical history was not significant. Extra oral examination revealed no facial asymmetry. Intra oral examination revealed unerupted maxillary right central incisor (Figure 1). Initially a provisional diagnosis of missing 11 was done.