Compound Odontome — MFDS Part 1 MCQ

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ModerateOral PathologyCompound OdontomeMFDS Part 1

A 10-year-old child is investigated because a permanent maxillary incisor has failed to erupt. A radiograph shows a well-circumscribed lesion in the anterior maxilla composed of multiple small, calcified tooth-like structures surrounded by a narrow radiolucent rim. What is the most likely diagnosis?

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Correct answer: B — Compound odontome

The diagnosis is a compound odontome. Its defining radiographic feature is a collection of multiple miniature tooth-like structures, or denticles, usually enclosed by a narrow radiolucent rim. The child's age, anterior maxillary location and failure of eruption are also characteristic. A complex odontome contains an irregular, amorphous mass of dental hard tissues rather than separate denticles. An adenomatoid odontogenic tumour commonly occurs in the anterior maxilla around an unerupted tooth and may contain fine calcifications, but it does not form multiple miniature teeth. Ameloblastic fibroma and ameloblastoma are predominantly radiolucent lesions and lack organised tooth-like structures.

Reference: Cheng FC et al. Radiographic characteristics of odontomas in patients in the National Taiwan University Children's Hospital. Journal of Dental Sciences. 2023;18(1):392-399. https://pubmed.ncbi.nlm.nih.gov/36643257/