The mechanism behind TMD causing otalgia and otolaryngological symptoms remains diffuse and unclear. Some of the theories proposed by researchers are as follows:

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Central ossifying fibroma is a rare, benign fibro osseous lesion that arises from the periodontal ligament. Odontoma is one of the most common odontogenic tumors containing enamel, dentin, cementum, and pulpal tissue. A 15-year-old boy came to our department with the chief complaint of missing teeth and malocclusion. On complete clinical and radiological investigations, we suspected a fibro osseous lesion and an odontoma occurring in the same site in the mandible, which was confirmed histopathologically to be complex odontoma and central ossifying fibroma. The patient was treated with en bloc resection and iliac crest graft. Such hybrid tumors where there is a synchronous occurrence of two tumors have been rarely reported in literature. There has been no established correlation in such cases but reporting more such cases may help in the establishment of a relationship.