CBCT in the detection of odontoma

Research output: Other contribution

Abstract

OBJECTIVES: Odontoma is the most commonamong odontogenic tumors, representing22- 23.9% of them. Impaction, aplasia, malformation,malpositioning, and devitalization ofadjacent teeth are associated with 50-70% ofodontomas. Two types of odontoma are distinguished,compound and complex. The typicalfeatures of compound odontoma are separate,rudimentary, closely positioned toothlike structures. When such buds form an amorphous andirregular conglomerate of dental tissue withouta clear division, they are classified as complexodontoma. Both types are recognized more frequentlyin the permanent dentition, typically inthe second or third decade of life. The anteriormaxilla and the posterior part of the mandibleare most commonly affected sites. CBCT findingsin the detection of odontoma is reported.MATERIALS AND METHODS: 5 patients (4 women,1 man, ranging from 12 to 51 years) werestudied by a CBCT device with 90 KV and 13mA, o,34 voxel size. Panoramic, cross sectional,multiplanar and 3D reformations were acquired.RESULTS: 3 complex and 2 compound odontomaswere found. Odontomas were located:1 in the right maxilla, 2 in the left maxilla, 1 inthe left mandible, 1 in the right mandible. In thepatient with odontoma in the right maxilla, itwas adjacent to the nasopalatin canal, causedthe impaction of 11, with persistency of 51. Of the2 odontomas in left maxilla, one was adjacent tothe maxillary sinus floor, the other one was buccallyerupted. The odontoma in the left mandible wascontiguous to the mandibular canal wall.RESULTS: Making a final diagnosis of odontomaonly relying on panoramic or periapical radiographicappearance alone often presents achallenge, because odontomas can mimic otherosseous or fibro-osseous lesions, and its recognitiondepends also on its position with respect tothe x-ray beam incidence, due to overimposedadjacent anatomic structures or lesions, that canpartially masquerade odontoma. Therefore, fordifferential diagnosis and treatment planning, theuse of CBCT is highly recommended. CBCT infact, thanks to tridimensional high resolutiondata acquisition, allows a correct identificationof odontoma, avoiding overimposed structurednoise, and of its relationship to contiguous anatomicstructures.CONCLUSIONS: Making a final diagnosis of odontomaonly relying on panoramic or periapicalradiographic appearance alone often presents achallenge, because odontomas can mimic otherosseous or fibro-osseous lesions, and its recognitiondepends also on its position with respect tothe x-ray beam incidence, due to overimposedadjacent anatomic structures or lesions, that canpartially masquerade odontoma. Therefore, fordifferential diagnosis and treatment planning, theuse of CBCT is highly recommended. CBCT infact, thanks to tridimensional high resolutiondata acquisition, allows a correct identificationof odontoma, avoiding overimposed structurednoise, and of its relationship to contiguous anatomicstructures.
Original languageEnglish
Number of pages1
Publication statusPublished - 2012

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