Odontomas

Odontomas are the most common type of odontogenic tumor and are generally considered hamartomas rather than true neoplasms. They are benign growths composed of dental tissues such as enamel, dentin, cementum, and pulp, typically arranged in a disorganized way that reflects tooth development.

There are two main types of odontomas. Compound odontomas consist of multiple small tooth‑like structures and are usually located in the anterior maxilla. Complex odontomas are a disorganized mass of dental tissues that does not resemble a tooth and are more commonly found in the posterior mandible.

Most odontomas are asymptomatic and discovered incidentally on routine radiographs. They can interfere with eruption of permanent teeth or cause swelling if they become large. Radiographic evaluation is essential for diagnosis.

Radiographs show well‑circumscribed radiopaque lesions. Compound odontomas present as clusters of miniature tooth‑like units within a radiolucent follicular space, whereas complex odontomas appear as a single radiopaque mass with a radiolucent border.

Treatment typically involves surgical enucleation or excision of the lesion, with removal of any impacted tooth if indicated. Recurrence after removal is rare. The prognosis is excellent following complete excision.

Epidemiology and associations: odontomas usually present in individuals under 20 years of age, with no strong gender predilection. They can be associated with certain syndromes, such as Gardner syndrome and nevoid basal cell carcinoma syndrome, but most occur sporadically.