Another challenge to the dentist is identifying the appropriate location of the odontoma , if it is buccally or lingually positioned to the adjacent tooth or structures . The simple two point SLOB ( same lingual , opposite buccal ) technique or buccal object rule technique , involves taking two periapical radiographs at different angles . This technique is useful in localizing odontomas or impacted teeth . Radiation dose from this technique is low . Advent of cone beam computerized tomogram technology has made localization of pathology and impactions easier with considerably lower doses than medical computerized tomogram .
CONCLUSION
Odontomas are the most common odontogenic tumors , posing problems to the patient and dentist alike . Early and appropriate diagnosis is recommended . Realizing the challenges associated with odontomas will be vital to the management of the patient .
Fig . 1 . Gross picture of a compound odontoma
REFERENCES
1 . Barnes L , E . J ., Reichart P , Sidransky D ., World Health Organization of Tumours ; Pathology and genetics of head and neck tumours . 2005 : Lynon IARC press .
2 . Soluk Tekkesin , M ., et al ., Clinical and histopathological investigation of odontomas : review of the literature and presentation of 160 cases . J Oral Maxillofac Surg , 2012 . 70 ( 6 ): p . 1358-61 .
3 . Owens , B . M ., et al ., Dental odontomas : a retrospective study of 104 cases . J Clin Pediatr Dent , 1997 . 21 ( 3 ): p . 261-4 .
4 . da Silva , L . F ., et al ., Odontomas : a clinicopathologic study in a Portuguese population . Quintessence Int , 2009 . 40 ( 1 ): p . 61-72 .
5 . Kodali , R . M ., et al ., An unusual complex odontoma . J Maxillofac Oral Surg , 2010 . 9 ( 3 ): p . 314-7 . 6 . Gyulai-Gaal , S ., et al ., [ Mixed odontogenic tumors in children and adolescents ]. Fogorv Sz , 2007 . 100 ( 2 ): p . 65-9 .
7 . Boffano , P ., G . F . Bosco , and G . Gerbino , The surgical management of oral and maxillofacial manifestations of Gardner syndrome . J Oral Maxillofac Surg , 2010 . 68 ( 10 ): p . 2549-54 .
8 . Lee , B . D ., et al ., A case report of Gardner syndrome with hereditary widespread osteomatous jaw lesions . Oral Surg Oral Med Oral Pathol Oral Radiol Endod , 2009 . 107 ( 3 ): p . e68-72 .
9 . Hisatomi , M ., et al ., A case of complex odontoma associated with an impacted lower deciduous second molar and analysis of the 107 odontomas . Oral Dis , 2002 . 8 ( 2 ): p . 100-5 .
10 . Asaumi , J . I ., et al ., Evaluation of panoramic radiographs taken at the initial visit at a department of paediatric dentistry . Dentomaxillofac Radiol , 2008 . 37 ( 6 ): p . 340-3 .
11 . An , S . Y ., C . H . An , and K . S . Choi , Odontoma : a retrospective study of 73 cases . Imaging Sci Dent , 2012 . 42 ( 2 ): p . 77-81 . 12 . Toretti , E . F ., A . S . Miller , and B . Peezick , Odontomas : an analysis of 167 cases . J Pedod , 1984 . 8 ( 3 ): p . 282-4 . 13 . Kaugars , G . E ., M . E . Miller , and L . M . Abbey , Odontomas . Oral Surg Oral Med Oral Pathol , 1989 . 67 ( 2 ): p . 172-6 .
14 . Amado Cuesta , S ., et al ., Review of 61 cases of odontoma . Presentation of an erupted complex odontoma . Med Oral , 2003 . 8 ( 5 ): p . 366-73 .
15 . Korpi , J . T ., et al ., Removal of large complex odontoma using Le Fort I osteotomy . J Oral Maxillofac Surg , 2009 . 67 ( 9 ): p . 2018-21 .
16 . Sales , M . A . and M . G . Cavalcanti , Complex odontoma associated with dentigerous cyst in maxillary sinus : case report and computed tomography features . Dentomaxillofac Radiol , 2009 . 38 ( 1 ): p . 48-52 .
17 . Chen , Y ., et al ., Ameloblastic fibroma and related lesions : a clinicopathologic study with reference to their nature and interrelationship . J Oral Pathol Med , 2005 . 34 ( 10 ): p . 588-95 .
18 . Wanjari , S . P ., et al ., Dentigerous cyst associated with multiple complex composite odontomas . Contemp Clin Dent , 2011 . 2 ( 3 ): p . 215-7 .
19 . Serra-Serra , G ., L . Berini-Aytes , and C . Gay-Escoda , Erupted odontomas : a report of three cases and review of the literature . Med Oral Patol Oral Cir Bucal , 2009 . 14 ( 6 ): p . E299-303 .
20 . Ali Azhar , D ., M . Z . Kota , and S . El-Nagdy , An unusual erupted complex composite odontoma : a rare case . Case Rep Dent , 2013 . 2013 : p . 106019 .
21 . Tejasvi , M . L . A . and B . B . Babu , Erupted compound odontomas : a case report . J Dent Res Dent Clin Dent Prospects , 2011 . 5 ( 1 ): p . 33-6 .
Fig . 2A . a cropped panoramic radiograph depicting a compound odontoma in the right maxilla 2B . a cropped panoramic radiograph depicting a complex odontoma of the left posterior maxilla
Fig . 3A . Photomicrograph of a compound odontoma ( H & e x20 ) depicting pulp , dentin , and fragments enamel in a regular arrangement 3B . Photomicrograph of a complex odontoma ( H & e x20 ) demonstrating a haphazard arrangement of dentin and enamel
Fig . 4A . a cropped panoramic radiograph depicting an ameloblastic fibro-odontoma of the left mandible which was diagnosed histologically . radiographically , this bears resemblance to a complex odontoma 4B . a cropped periapical radiograph depicting a calcifying cystic odontogenic tumor with a complex odontoma of the anterior maxilla which was diagnosed histologically
S E P T / O C T 2 0 1 3 | P E N N S Y LVA N I A D E N TA L J O U R N A L 3 7