%0 Journal Article
%T Complex Composite Odontoma with Characteristic Histology
%A Sujatha Govindrajan
%A J. Muruganandhan
%A Shaik Shamsudeen
%A Nalin Kumar
%A M. Ramasamy
%A Srinivasa Prasad
%J Case Reports in Dentistry
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/157614
%X Odontomas are the most commonly occurring odontogenic tumors, which are considered by many to be hamartomas rather than neoplasms. These clinically asymptomatic tumors are classified into complex and compound odontomas. They are usually discovered in radiographs and rarely cause bony expansion or infection. This paper discusses a case report of a complex odontoma exhibiting all the structural features and defects of enamel, dentine, and cementum in succession, with an overview on its etiology. 1. Introduction Hamartomas of tooth forming tissues are termed as odontoma. They are the most common tumor of epithelial and mesenchymal origin and account for 22% of all odontogenic tumors [1]. This nonaggressive benign tumor contains enamel, dentin, cementum, and pulp either arranged in an orderly manner resembling a rudimentary tooth called compound odontoma or arranged in a haphazard manner called complex odontoma. Complex odontoma is less common when compared to the compound, and they present in ratio of 1£¿:£¿2 [2]. Odontomas rarely erupt in the oral cavity. We present a case of a partially erupted odontoma in the right third molar region. 2. Case Report A 28-year-old male patient reported to a private clinic with a complaint of pain in the right lower posterior tooth region for about one week. On intraoral examination, a partially erupted tooth-like structure was seen. The pain was intermittent and was aggravated on chewing. Radiographic investigation revealed the presence of near-spherical opaque mass resembling calcified tissue measuring about 2£¿cm in diameter. The radiopaque mass with a density greater than bone and equal or greater than that of tooth was surrounded by a radiolucent rim in all areas except the erupted portion distal to normally erupted second molar (Figure 1). Figure 1: Radiographic image of the odontoma. Removal of the mass was planned under local anaesthesia. Mucoperiosteal flap was raised distal to 47, and the calcified mass was removed. The spherical mass was about 2£¿cm in diameter with small irregular areas of indentations. The inferior side of the mass showed a hollow invagination giving the appearance of a small cup (Figure 2). The specimen was sent for histopathological examination. A diagnosis of complex odontoma was made clinically. Figure 2: Superior and inferior surface of odontoma. Ground sections were done on the dissected halves of the hard tissue mass. The ground section showed areas of enamel, dentine, and cementum in succession (Figure 3). The enamel showed uneven thickness and undulating surface. Hypocalcified areas like
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