Clinical Pathological Conference---Compound Odontoma

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Clinical Pathological Conference---Compound
Odontoma

• Wu Cheng-Hsien, Division of Oral Maxillofacial
  Surgery, Department of Dentistry, V.G.H.-Taipei

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• General Data
• Name ? X X
• Chart No. 2935590-6
• Ward No. B10816
• Sex Male
• Birthday 74/02/08
• Marital status Single
• Date of admission 89/06/19
• Occupation Student

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• Chief Complaint
• Refer from LDC for removal of radiopaque lesion
  over Rt lower mandibular region.
• History of Present Illness
• According to the statement of this 15 y/o boy,
  a few days ago , he went to LDC for regular
  dental check-up and scaling. The Dr. take the
  apical film found this odontoma and suggested
  him to visit VGH OS OPD for help. So he admitted
  our ward B108-16 for surgery intervention for
  odontoma removal under GA.

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• Past Medical/Dental History
• General DM(-) , HTN(-) , Heart disease (-)
• Allergies food and drug(-)
• Trauma significant injuries (-), blood
  transfusion (-)
• Social and Personal History
• Tobacco Nil
• Alcohol Nil
• Betel quid chewing Nil
• Family History
• Family lipoma history , and now there is a lipoma
  over his right arm.
• Review of Systems
• No specific finding

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• OMS condition
• Extraoral No facial asymmetry
• No LAP
• Intraoral retained deciduous tooth 83
• Pano. Finding
• gtImpaction18,28,38,48
• gtA well-defined radiopaque-radiolucent lesion
  with radiolucent encapsulation about 1.5x1.5cm
  over 42-45 apical area
• gt33 ectopic eruption

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Odontoma

• General features
• Mixed odontogenic tumor epithelial and
  mesenchymal origin A kind of harmatoma
• Etiology
• Result from an extraneous bud of odontogenic
  epithelial cells from the dental lamina
• Epidemiology
• The most common odontogenic tumor(67)
  Compoundgt Complex(21)gt ameloblastic odontomagt
  ameloblastic fibroodontoma

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• Age
• Occur in the 2nd decade of life (most common
  in childen and young adults)
• Sex
• MF (68 of the complex type occur in women)
• Site
• Compound---incisor-canine area of the
  maxilla Complex-- 1st and 2nd molar of the
  mandible
• Size 1-3cm
• Progress Non-aggressive
• Symptoms
• Delayed eruption of permanent tooth

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Ameloblastic odontoma (AO odontoameloblastoma)

• Simultaneous occurence of an ameloblastoma and
  complex odontoma
• Clinical similarities to both the odontoma (age
  at time of diagnosis) and ameloblastoma
  (location, expansion and recurrent rate)
• aggressive rare benign
• More often in children early in the 2nd decade of
  life ?gt? mandiblegtmaxilla
• Bony expansion cortex destruction teeth
  displacement mild pain

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Ameloblastic Fibroodontoma

• Contain cords nests of odontogenic epithelium
  some calcified odontogenic tissue in a myxomatous
  stroma
• benign, well-capsulated
• ?gt? most often in the first two decades of life
• mandiblegtmaxilla most in the premolar-molar area
• pericoronal to an imbedded tooth
• radiolucent--gtradiolucent-radiopaque
• D.D. COC AOT CEOT odontoma
• Management surgical enucleated