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Odontomes / Odontomata
What is an Odontome?  

Odontomata are benign calcifying hamartomata and are the most common type of odontogenic harmartoma
among patients younger than 20 years.

These
hamartomata are composed of various dental tissues, that is, enamel, dentine, cementum and sometimes
pulp.

They are classified as
complex, when the calcified tissues present simply as an irregular mass composed mainly
of mature
tubular dentine or compound, if there is superficial anatomic similarity to rudimentary teeth (many
seperate, small, tooth-like structures,
denticles).

Odontomata are rare jaw lesions that affect less than 1% of the population.
Last Updated 25th October 2020

Complex odontomata tend to occur in the posterior (hindmost) region of the jaw and compound odontomata are
more common in the
anterior maxilla (front upper jaw).   They may be discovered at any age although less than
10% are found in patients over 40 years of age.

In children,
odontomes mainly result in eruption disturbances of the permanent teeth, whereas this is rare regarding
the
primary dentition (baby teeth).

Odontomata may be diagnosed at any age but they are usually detected during the first two decades of life.  One
study analyzed 396 cases and showed that diagnosis usually happens between ages 11 and 15 years.  Another
study, comprising 149 cases, concluded that the
odontomes are detected most often during the second decade of
life.  

Many times,
odontomata are found associated with unerupted teeth.  The canines, followed by upper central
incisors and 3rd molars (wisdom teeth), are the most frequent  teeth impacted by
odontomata.

In a very few instances
odontomata are related to missing teeth.  Generally, these malformations are intra-osseous
(within the bone) but occasionally they may erupt into the oral cavity.


Although they are commonly asymptomatic, clinical indicators of
odontoma may include retention of deciduous
teeth
(baby teeth), non-eruption of permanent teeth, pain, expansion of the cortical bone and tooth displacement.

Other symptoms include anaesthesia in the lower lip and swelling in the affected area.

Eruption of an
odontoma through the mucosa could also allow invasion of oral micro-organisms into the bone due to
lack of adequate adhesion between bone and
odontoma because of the absence of periodontal ligament.


Odontomata can measure anywhere from a few millimetres to many centimetres in their greatest dimension.  The
largest found in a human weighed 0.3 kg.


Radiographic aspects of
odontoma are characteristic.


The
complex odontoma appears as an irregular mass of calcified material surrounded by a thin radio-lucent area
with smooth periphery and the
compound type shows calcified structures resembling teeth in the center of a
well-defined
radio-lucent lesion. A periodontal and peri-coronary space characteristic of unerupted teeth is seen
around each tooth.

A developing
odontoma can be discovered by routine radiography but may cause difficulty in identification due to
lack of calcification.
Radiographs of Odontomata




Useful Websites:


BMJ Case Reports

J Oral Maxillofacial Pathology

National J Maxillofacial Surgery

Radiopedia

Wikipedia


Useful Articles:

Pediatr Dent 2001.  Compound Odontoma – Diagnosis & Treatment.  3 Case Reports

BDJ 2008. Erupted Compound Odontoma - Case Report of a 15-year-old Sudanese boy with a History of
Traditional Dental Mutilation

JOMS 2008.  Multiple Compound Odontomas in the Jaw - Case Report & Analysis of the Literature

Intl J Clin Ped Dent 2011.  Odontome - A Brief Overview

Imaging Science in Dentistry 2012.  Odontoma - A Retrospective Study of 73 Cases

Case Reports in Dentistry 2015.  Case Report.  Surgical Management of Compound Odontoma associated with
Unerupted Tooth

Niger J Clin Pract 2015.  Complex & Compound Odontomas.  Analysis of 69 Cases & a Rare Case of Erupted
Compound Odontoma

Revista Odontológica Mexicana 2016.  Descriptive Aspects of Odontoma - Literature Review

Meandros Med Dent J 2017.  Surgical Treatment of a Large Complex Odontome

Clin Surg 2018.  Compound Odontoma-Diagnosis & Treatment in Pedıatrıc Dentıstry - 3 Case Reports

J Oral Dis Markers 2018.  Odontoma - A Brief Review

Pediatr Dent 2018.  Case Report.  A Bag of Marbles - A Fascinating Compound Odontoma of the Maxilla

Ear, Nose & Throat J 2019.  Pathology Clinic.  Odontoma

J Clin Exp Dent 2019.   Odontomas are associated with impacted permanent teeth in orthodontic patients

Oncology & Radiotherapy 2019.  Case Report.  Compound Odontoma in Anterior Maxilla