Odontomas are one of the most common of mandibular lesions encountered and the most common odontogenic tumors of the mandible. They account for up to two-thirds of all such tumors; the next most common are ameloblastomas, making up the majority of the remaining one-third.
They can occur at any age, although typically are diagnosed in the 2nd decade of life.
They can be thought of as a 'tooth hamartoma', with the lesion consisting of various tooth components (dentin, cementum, pulpal tissue, and enamel). They are divided histologically into:
- complex odontoma: irregular calcified lesions with no distinct tooth components
- compound odontoma: identifiable tooth components
Approximately half will be associated with an unerupted tooth, the rest being diagnosed both before or after tooth eruption.
Initially, the tumor is lucent, but with time, it develops small calcifications which eventually coalesce to form a radiodense lesion with a lucent rim.
Epithelial components may occasionally give rise to a dentigerous cyst.
Treatment and prognosis
Surgical resection is the treatment of choice and there is no recurrence.
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