Odontoma

Most common odontogenic tumor is an Odontoma.  Odontomas are considered to be hamartomas rather than neoplasms. These lesions are composed of tissues native to teeth: enamel, dentin, cementum and pulp tissue. 

Odontomas are classified based on their gross and radiographic features into compound (small tooth like structures) or complex (a conglomeration of dentin, enamel and cementum)  Clinical symptoms are uncommon, however, an affected patient may present when a permanent tooth or multiple teeth that fail to erupt.

Usually, odontomas can be confidently subclassified based on the Xray appearance. Compound odontomas appear as a collection of small teeth. Complex odontomas appear as a radioopaque mass  which may result in a wider differential diagnosis.

Below is a case of a 16 year old male who was referred  for removal of his wisdom teeth. Panoramic x ray was consistent with compound odontoma. CT scan was obtained to assess best access point to remove the lesion.  

Traumatic Bone Cyst

The traumatic bone cyst is an uncommon non epithelial lined cavity of the jaws. The cyst is mainly diagnosed in young patients most frequently in their teen. Most of these lesions are located in the mandible.  These lesions are asymptomatic in the most of cases and are often discovered on routine dental X-rays. Since epithelial lining is non existent,  microscopic diagnosis may be difficult.

Below see a Ct scan of a 15 Year old male athelete presenting to our office with large cystic lesion of left mandibular body which was discovered on panoramic x ray when he was consulting an orthodontist.

At surgery, we discovered a large cystic lesion devoid of any epithelium. Scrapings of the cyst was consistent with diagnosis of Traumatic bone cyst per pathologist.

The  recommended treatment for this lesion is surgical exploration followed by curettage of the bony walls.

The surgical exploration serves as both a diagnostic  and as definitive therapy by producing bleeding in the cavity. Blood clot formation in the cavity is eventually replaced by bone.