A Rare Case of Compound Odontome with Impacted Tooth: Understanding Clinico-Radio-Histopathological Aspects

Odontomes are hamartomatous lesions of odontogenic origin. Odontomas can occur at any age but are typically identified within the first two decades of life. They have been classified under ‘Benign Mixed Epithelial & Mesenchymal Odontogenic Tumors’ by WHO 2022 and categorized into compound and complex types. Odontomes usually have slow growth and benign behaviour and hence, are mostly detected as incidental findings on standard radiographs. Occasionally, they may cause complications such as delayed tooth eruption, impaction, deflection, or retention of teeth. Previous studies have shown only 2% of cases to be associated with the impaction of a deciduous tooth. We hereby report a case of a compound odontoma in a 5-year-old child causing impaction of a deciduous canine. Intraoral examination revealed the presence of unerupted left maxillary deciduous canine (63) and a fairly delineated, dome-shaped swelling in the left maxillary anterior region extending from the distal surface of left maxillary deciduous lateral incisor (62) to the mesial surface of left maxillary deciduous first molar (64), causing obliteration of labial vestibular sulcus. Surgical excision of the mass in toto was performed under general anaesthesia. Despite having limited growth potential, odontomes may lead to complications like cystic change or interference with normal occlusion which necessitates its surgical removal and subsequent periodic monitoring. Thus, regular assessment of dentition is of paramount importance as early diagnosis of odontomas permits simpler, less expensive treatment plans and ensures a better prognosis.