An odontoma, also known as an odontome, is a benign tumour linked to tooth development. Specifically, it is a dental hamartoma, meaning that it is composed of normal dental tissue that has grown in an irregular way. It includes both odontogenic hard and soft tissues.
The average age of people found with an odontoma is 14. The condition is frequently associated with one or more unerupted teeth and is often detected through failure of teeth to erupt at the expected time. Though most cases are found impacted within the jaw there are instances where odontomas have erupted into the oral cavity.
There are two main types: compound and complex.
- A compound odontoma still has the three separate dental tissues (enamel, dentin and cementum), but may present a lobulated appearance where there is no definitive demarcation of separate tissues between the individual "toothlets" (or denticles). It usually appears in the anterior maxilla.
- The complex type is unrecognizable as dental tissues, usually presenting as a radioopaque area with varying densities. It usually appears in the posterior maxilla or in the mandible.
In addition to the above forms, the dilated odontoma is an infrequent developmental alteration that appears in any area of the dental arches and can affect deciduous, permanent and supernumerary teeth. Dens invaginatus is a developmental anomaly resulting from invagination of a portion of crown forming within the enamel organ during odontogenesis. The most extreme form of dens invaginatus is known as dilated odontoma.
In the 4th edition of the World Health Organization (WHO) Classification of Head and Neck Tumors (published in January 2017), there is a new section added on odontomas that speculates on a relationship between developing odontomas and ameloblastic fibromas/ameloblastic fibrodentinoma and ameloblastic fibro-odontoma.
Odontomas are thought to be the second most frequent type of odontogenic tumor worldwide (after ameloblastoma), accounting for about 20% of all cases within this relatively uncommon tumor category which shows large geographic variations in incidence.
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