Odontoma Preventing Eruption — ORE Part 1 MCQ

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ModerateRadiology & ImagingOdontoma Preventing EruptionORE Part 1

A panoramic radiograph of a 13-year-old shows bilateral clusters of multiple small tooth-like radiopacities, each surrounded by a narrow radiolucent rim, in the regions of the unerupted mandibular second premolars. What is the most likely diagnosis?

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Correct answer: D — Compound odontomas

The diagnosis is **compound odontomas**. Their characteristic appearance is a cluster of multiple miniature tooth-like calcified structures (denticles), typically enclosed by a narrow radiolucent follicle-like rim. They commonly present in children or adolescents because they obstruct or delay eruption of a permanent tooth. Cementoblastoma is usually a single radiopaque mass fused to the root of a vital tooth, rather than separate denticles. Periapical cemento-osseous dysplasia usually affects mandibular anterior tooth apices in older adults and does not prevent eruption. Dentigerous cysts are principally radiolucent and attach at the cemento-enamel junction of an unerupted tooth. Ameloblastomas are usually expansile multilocular radiolucent lesions, not clusters of tooth-like radiopacities.

Reference: Lin YT, et al. Radiographic characteristics of odontomas in patients in the National Taiwan University Children's Hospital. Journal of the Formosan Medical Association, 2023. https://pubmed.ncbi.nlm.nih.gov/33723756/