ABSTRACT
Background & Objective: To document and discuss clinical features, evaluation for need of treatment of 30 radiographically and histopathologically proven cases of compound and complex odontomes of the jaw bones monitored and operated by single surgeon during 5 years. Methodology: A retrospective investigation of 30 cases of compound composite and complex composite odontomes was done. The study was performed using medical records, panoramic radiographs and pathological reports. Data gathered included age/gender, location, chief complaints, effect on dentition and treatment rendered. Results: 16 cases of compound odontoma detected in 1st & 2nd decades of life had 6 accidentally discovered on radiographs and 10 complaining of missing permanent teeth. 14 cases of complex odontoma discovered during 3rd -6th decades , 8 with complaint of the pain & paraesthesia of the affected region and 6 discovered accidentally on radiographs. None of the odontomes showed gender predilection. Considering the state of presentation, associated complaints and possible complications surgical treatment was done in symptomatic patients & asymptomatic patients were kept on follow up. Chi-square test performed was statistically insignificant (Chi Sq=0.089, df=1, p-Value >0.1). Conclusion: Odontoma, a benign odontogenic tumor usually has least propensity towards aggressiveness or malignant transformation. Treatment protocol of individual cases should be customized by considering the presenting complaints ,symptoms & natural progression of the concerned lesion. Considering the above factors, all cases of odontomes need not be surgically removed unless it grows to a potential large size causing gross facial deformities, pain & paraethesia of affected facial region or impaction of multiple permanent teeth.
ABSTRACT
Desmoplastic Ameloblastoma is a rare variant of ameloblastoma. 90 cases of desmoplastic ameloblastoma have been reported so far in literature. We are presenting a rare case of desmoplastic ameloblastoma in the ramus region of mandible with regards to its clinical and radiographical viewpoints. Only one other case of desmoplastic ameloblastoma has been reported in the ramus region of mandible of the 90 cases that we have reviewed. Review of literature has revealed the tumour to most commonly occur in the 3rd to 5th decade of life with a high preponderance of Japanese males. The anterior region of either jaw was most commonly found to be affected. Radiological appearance was most commonly of a mixed radio-lucent/radio-opaque type with a high incidence of poorly defined borders. However our case differed from the reviewed cases as it was found to be a unilocular lesion with well defined borders. Histopathological findings of our case were consistent with the hisotpathological appearance of the reviewed cases and showed extensive stromal desmoplasia and small tumour nests of odontogenic epithelium scattered in stroma.