Histopathological insight of complex odontoma associated with a dentigerous cyst

Abstract

Odontomas and dentigerous cysts are common findings for practicing dental professionals. However, simultaneous occurrence of pathologies like odontoma and dentigerous cyst are uncommon and their diagnosis based on the radiographic appearance alone is a challenge to overcome. They together are a potential for complications like attaining large size, root resorption, destruction of the jaw bones and sometimes neoplastic changes like ameloblastoma. This paper presents a case of complex odontoma associated with dentigerous cyst in relation to a retained deciduous tooth in the maxillary anterior region and confirming its diagnosis histopathologically.

A giant mandibular dentigerous cyst associated with a compound odontoma: A case report

“…Complications associated with dentigerous cysts includes; Pathological bone fracture, loss of permanent teeth, bone deformities and the development of malignancies such as ameloblastoma, squamous cell carcinoma and intraosseous mucoepidermoid carcinoma. 1,2,5,7,8 In this case, the patient had to lose all the teeth in the region due to asymptomatically enlaged cyst and was not noticed for a long time. In our opinion, it can be considered a great chance for the patient not to have a trauma to the region in the presence of this cyst, which can cause jaw fracture very easily.…”

“…Odontomas are considered developmental malformations (hamartoma) more than benign neoplasms. 1,3,5,10 It is thought that odontoma is caused by budding of extraodontogenic epithelial cells from dental lamina. This cell cluster forms a large mass of dental tissue that can settle in an abnormal configuration but consists of normal enamel, dentin, cementum and pulp 1 .…”

“…It is estimated that 27% of cases related to an odontoma. 1,2 In 1867 Paul Broca described odontoma as a non-aggressive benign ectomesenchymal tumor of unknown origin. Odontomas may be associated with the presence of impacted teeth, trauma, genetic factors, local infections and dentigerous cysts.…”

“…These can lead to variable problems, from aesthetic and phonetic to severe malocclusions. 1,2 For this reason, early and accurate diagnosis of cyst and its cause is of great importance. Treatment of odontoma is surgical excision and this treatment is very successful, recurrence is rarely seen, and bone repair is done smoothly in the area.…”

“…Odontomas may be associated with the presence of impacted teeth, trauma, genetic factors, local infections and dentigerous cysts. 1,3 Preliminary diagnosis of both lesions is done by the main imaging methods and then confirmed by histopathological analysis. Failure to diagnose or treat, especially after the cyst has reached enormous dimensions, can cause pathologic bone fractures and resection of the jawbone.…”