This document discusses odontomas, which are benign odontogenic tumors composed of dental tissue like enamel, dentin, and pulp. There are two main types: compound odontomas, which appear like small tooth structures, and complex odontomas, which have a disorganized appearance. Odontomas are usually asymptomatic and discovered incidentally on x-rays during dental exams. On x-rays, they appear as radiopaque masses surrounded by a radiolucent rim. Treatment involves simple surgical removal, with an excellent prognosis and no recurrence.

1. ODONTOMA
Compound odontoma,
complex odontomas,
odontogenic hamartoma.

2. ONE OF THE TUMORS OF ODONTOGENIC EPITHELIUM
This group of tumors is composed of proliferating odontogenic
epithelium in a cellular ectomesenchyme resembling the dental papilla.

4. Odontomas are composed of all mature components of
dental hard and soft tissue: enamel, dentin, and pulp
tissue. Because of their limited slow growth and well-
differentiation, they are generally considered to
represent hamartomas rather than true neoplasm
DEFINITION

5. CLINICAL FEATURES
•They are the most common odontogenic tumors
• and they interfere with eruption of permanent teeth.
• They begin to develop as normal dentition start to
•develop and cease when the teeth development ends.
• There is no sex predilection.
•Theyoccur in young age group, with the average age being
second decade of life.

6. CLINICAL FEATURES
• They are usually asymptomatic and are
discovered during routine radiographic
examination when there is delayed eruption of
permanent tooth.
 Location: Somewhat more common in the maxilla.
The compound type is more often in the anterior
maxilla while the complex type occurs more often
in the posterior regions of either jaw.

7. TWO TYPES OF ODONTOMAS ARE
RECOGNIZED
 Complex  Compound

8. COMPOUND ODONTOMA
It is a collection of small radiopaque masses,
some or all may be tooth-like structures
“denticles”.
It tends to occur in 62% in the anterior region of
the maxilla and usually associated with the crown
of an unerupted canine. It is formed by exuberant
growth of the dental lamina or into a number of
small enamel organs by proliferation of the
enamel organ.

9. COMPLEX ODONTOMA
 It is composed of haphazardly arranged dental
hard and soft tissue. It has no resemblance to
a normal tooth. It tends to occur in 70% in the
posterior region of the mandible. There might
be a missing tooth if it arises from a normal
tooth follice.

10. RADIOGRAPHIC FEATURES
Early lesions are radiolucent with smooth, well-defined contours.
Later a well-defined radiopaque appearance develops.
Most odontomas are small and do not exceed the size of a normal
tooth in the region.
However, large ones do occur and these may cause expansion of
the jaw.
Most odontomas are asymptomatic and as a result are discovered
upon routine radiographic examination.

11. RADIOGRAPHIC FEATURES
*Odontomas may block the eruption of a
permanent tooth and in these cases are often
discovered when “searching for” the “missing”
tooth radiographically.
*They can be associated with impacted,
malposition, malformation, and displacement
of adjacent teeth.

12. COMPLEX ODONTOMA RADIOGRAPHICLLY
 Common lesions that persist through life
 Usually detected in adolescence
 most commonly in mandibular molars
 not painful, or swelling
 radiographically "sunburst radiopacities, thin
uniform radiolucent rim
 similar description as osteosarcoma, but assoc
w/ tooth, clear of bony borders

15. • large radioopaque
lesion
• well encapsulated w/
radioiolucent border

16. COMPOUND ODONTOMA RADIOGRAPHICLLY
*Most common odontogenic tumor
*Appears as a cluster of multiple abortive teeth
*Often prevents normal tooth eruption
*Radiographically multiple tiny toothlike structures
are contained within a fine radiolucent rim
*Do not recur after excision
*thus discovered during adolescence
Histology of compound odontomas approaches
normal tooth strcture. Gross clinical examination
usually is sufficient for diagnosis.

19.  3 small radioopaque
lesion w/ radiolucent rim

20. DIFFERENTIAL DIAGNOSIS
Compound odontomas can be detected easily
due to their tooth-like appearance. Complex
odontomas can be differentiated from
cemento-ossifying fibromas due to their
propensity to be associated with crown of
unerupted molar and they are more radiopaque
than cement-ossifying fibromas.
 They can also develop at much younger age
than cemento-ossifying fibromas.

21. DIFFERENTIAL DIAGNOSIS
 A dense bony island can be included in the
differential. However, the presence of a soft
tissue capsule is very useful in differentiation.
Periapical cemental dysplasia may resemble
complex odontomas but usually they are
multiple, surrounded by sclerotic borders and
centered around apices of teeth, whereas
odontomas are commonly found occlusal or
overlapping the involved teeth.

22. TREATMENT
 Odontomas are treated by
simple local excision and
the prognosis is excellent
 They don’t recur and are not
invasive.

23. Case Reports
HISTORY:
A 28-YEAR-OLD FEMALE WAS REFERRED FOR A
CONE BEAM CT SCAN FOR EVALUATION OF LEFT
MANDIBULAR CANINE/PREMOLAR AREA FOR
PATHOLOGY.
FINDINGS:
THERE IS A WELL-DEFINED MIXED DENSITY
LESION BETWEEN ROOTS OF TEETH #20-21. THE
LESION IS SURROUNDS BY RADIOLUCENT BAND
AND RADIOPAQUE CORTEX GIVING IT A TARGET
APPEARANCE. THE HETEROGENEOUS DENSITY
WITHIN THE LESION HAS TOOTH LIKE
APPEARANCE AND DENSITY. IT MEASURES
APPROXIMATELY 12 MM AT ITS GREATEST
DIMENSION. THERE IS DISPLACEMENT OF ROOTS
OF #20 AND #21. THERE ARE NO SIGNS OF ROOT
RESORPTION. THE LESION IS IN CLOSE PROXIMITY
TO THE MENTAL FORAMEN. THE MANDIBULAR
CANAL IS LOCATED INFERIOR AND BUCCAL TO THE
LESION.