Complex odontoma (40X)
Clinical information: In a 16-year-old boy, tooth number 17 was retained, and there was a fixed retraction in the buccal region of theeth 16 and17. X-rays showed densifications that pointed in the direction of an odontoma. The tumor was removed.
Clinical diagnosis: Odontoma.
Microscopic examination: the section show an incompletely formed molar with an intact pulp and normal dentine. The enamel of the crown is dissolved by acid during the decalcination process when preparing the tissue specimen, and remnants of the reduced enamel epithelium cover the dental follicle. Along the reduced enamel epithelium and situated over the occlusal part of the dissolved enamel, a conglomerate-like mass is found that is the tumor tissue. It is essentially made up of a compact tissue and with the largest measurement of 2 x 1.9 cm. This dense tissue mostly consists of dentine and osteodentine with some cement-like substance and numerous larger and smaller cavities that partly contain reduced enamel epithelium and remnants of acid-soluble enamel (basophilic and eosinophilic network). One also finds some pulp-like connective tissue partly interspersed with islands of odontogenic epithelium. Peripherally, a connective tissue capsule can be seen in some places (corresponds to the dental follicle in normal odontogenesis).
About complex odontomas: A complex odontoma is a type of odontogenic tumor that can develop in the jaw or the surrounding oral structures. Odontomas are considered to be the most common type of odontogenic tumors. They are generally benign (non-cancerous) and slow-growing, but they can cause dental problems and require treatment.
There are two main types of odontomas: compound odontomas and complex odontomas.
A complex odontoma is characterized by a disorganized mass of dental tissues, including enamel, dentin, cementum, and pulp, which do not resemble normal tooth structures. These masses can interfere with the eruption of teeth, cause pain, or lead to other dental issues. Complex odontomas may contain various dental components, but they lack the organized, tooth-like appearance seen in compound odontomas.