A new small clinical case :
patient is sent to you by his radiologist with an OPT showing this:
ir_op.jpg

Here is a Zoom on the interesting portion of the image:
ir_opt_zoo.jpg

What is your diagnosis and what treatment do you recommend

Thanks Bassam,
Well, my initial diagnosis is Cementoma (cementosis) or odontoma .

Treatment plan:

1) we should take an apical radiograph in order to make sure it's not an artificial x-ray error
2) If it's true and the case is asymptomatic, NO TREATMENT required
3) We can follow the case to determine any change in the size of lesion, or if any symptom has appeared.


From the OPT again, I think I could note a similar finding at the area of the distal root of the tooth 48 but in less degree (maybe!!), but it doesn't require any surgical approach too.

Good reading Wesam

Anyway I have some elements to add:

*The exact diagnosis can only be done by the anatomopathologist.

However, a radiopaque tumour of the jawbones is often not serious (limited to one tissue and non invasive tumor It evolves & moves only a little )
One can evoke an OSTEOMA or a CEMENTOMA (an odontoma really looks different from my small experience).

The treatment will be the monitoring and the exeresis only in the event of pain.

Thanks Bassam,

I think some cases of COMPLEX ODONTOMA may appear very similar to this case, whereas COMPOUND ODNOTMA looks very different.

But we can exclude Odontoma from the diagnosis of this case cus it often causes displacement and prevents the eruption of adjacent teeth which is not occurred in the case here.

Look for this Photo of Complex Odontoma



and this for Compound Odontoma



Therefore, the differential diagnosis comprises: Cementoma, and Osteoma.

Cheers

hello Wesam thanks for participation,
an odontoma really doesn't look like a cementoma or an osteoma for 2 reasons :
- First one : an Odontoma is noticeably more radio-opaque than other lesions (presence of enamel).

- Second reason : An odontoma doesn't show the same characteristics, I mean an odontoma usually (always?) looks independent (individualized structure surrounded by bone) I've not seen one that is attendant to other structures like the case.

Hello mate,

well, I'm with you that there is some difference in the radiographic appearence of the odontoma and cementoma.

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