A constellation of pathophysiologic processes may serve to alter the orderly eruption of teeth into the oral cavity. The odontoma, regarded as a hamartoma, is usually found in tooth-bearing segments of the jaws, often producing delayed eruption or impaction of a permanent tooth, 1 with a limited number of cases promoting ectopia of a supernumerary 2 or primary tooth. 3 The incidence of odontomas in various cohorts is 0.54%-0.89%. 4,5 In fewer situations, a developing tooth may be displaced intraosseously beyond the midline (referred to as transmigration), seen in only 0.007%-0.08% of patients, the vast majority involving mandibular canines. 6,7 An even greater rarity is the concurrence of an odontoma adjacent to a transmigratory tooth, predominately affecting mandibular canines. 8 The article reports the incidental synchronous findings in a 66-year-old woman, consisting of a compound odontoma, transmigrated canine, florid cemento-osseous dysplasia, hypercementosis and moderate to severe periodontitis. In view of the affected