PMC9085339_01
The image shows the size of the lesion in the CBCT scan approximately 10 years before its removal.
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The patient underwent an initial cone beam computed tomography (CBCT) scan in 2010 and two different orthopantomographs, in 2013 and 2019, respectively (Figures 1-3).
Orthopantomography performed in 2013.
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The patient underwent an initial cone beam computed tomography (CBCT) scan in 2010 and two different orthopantomographs, in 2013 and 2019, respectively (Figures 1-3).
Orthopantomography performed in 2019.
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The patient underwent an initial cone beam computed tomography (CBCT) scan in 2010 and two different orthopantomographs, in 2013 and 2019, respectively (Figures 1-3).
CBCT scan performed in 2020, showing the enlargement of the lesion compared to the first CBCT scan.
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By comparing the two orthopantomographs, it was possible to appreciate an expansive growth of the lesion; therefore, a new CBCT scan was prescribed in 2020 (Figure 4).
Vision of the vestibular bone hatch.
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The lesion measuring 15 x 10 x 7 mm was sent to the anatomical pathology department for histopathological examination (Figures 5-7).
Removal of the lesion through the bone hatch.
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The lesion measuring 15 x 10 x 7 mm was sent to the anatomical pathology department for histopathological examination (Figures 5-7).
Lesion with millimeter probe.
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The lesion measuring 15 x 10 x 7 mm was sent to the anatomical pathology department for histopathological examination (Figures 5-7).
Representative histological pictures of the lesion. (a) The odontoma has a well-organized tooth-like structure composed mainly of dentin (d) with a thin outer layer of cement (c) and little inner dental pulp-like tissue (p). (b) It is appreciable a thin fibrous wall (w) with brown hemosiderin deposits of a cystic lesion ((a) 50x magnification). At higher magnification, the cyst is covered by a hyperplastic nonkeratinizing squamous epithelium (s) with exocytosis of neutrophils (arrow, (b) 100x magnification) (haematoxylin-eosin staining).
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The tooth-like structure was mainly composed of dentin with a thin outer layer of cement and little inner dental pulp-like tissue, compatible with compound odontoma (Figure 8).
Orthopantomography performed in 2021.
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No recurrence was observed at the 12-month follow-up recall (Figure 9).