New therapeutic options in the treatment of odontomas

A case report

Abstract

Odontoma is a benign, odontogenic tumour composed of mixed epithelial and mesenchymal tissues. Based on the literature
recurrence is rare after complete extirpation. In our case, we present a two-stage surgical treatment approach
for a recurrent complex odontoma, which was first operated two years earlier. The twenty-year-old patient presented an
abscess localized to the area of the right mandibular angle. The radiological images, revealed an area filled with an odontoma-
like lesion and the impacted lower wisdom tooth. Due to the risk of jaw fracture and alveolar nerve injury, a twostage
surgical procedure was applied from intraoral access. During the first surgery, the odontoma was removed and
the bony defect was marsupialized. Four months later, the right lower wisdom tooth and the epithelial lining of the bony
defect were removed. The second surgery was performed without alveolar nerve injury, the bony defect was filled with
platelet-rich fibrin and primarily wound-closure was applied. Healing was uneventful. During three month healing time the
original anatomical conditions were reconstructed in the previous surgical area.