Dilated Odontoma of the Mandible: A Rare Case Report with Discussion about the Differential Diagnosis.

Abstract

Dilated odontoma is a rare developmental anomaly considered the most severe form of dens invaginatus (dense in dente). It results from a deep enamel-lined invagination into the dental papilla before mineralization, forming a ring-shaped radiopaque mass with a radiolucent center. Anterior mandibular involvement is uncommon. Familiarity with the radiographic features of this lesion is crucial for dental practitioners to make an accurate diagnosis. We report a case of a 12-year-old girl with a painless bony hard swelling in the anterior mandible. Panoramic radiograph revealed a well-defined, doughnut-like radiopaque lesion along with an unerupted permanent canine. The provisional diagnosis was dilated odontoma and ameloblastic fibro-odontoma. The treatment plan consisted of surgical removal of the lesion, followed by histopathologic study to confirm the initial diagnosis. Dilated odontoma may lead to permanent tooth impaction, particularly in atypical locations such as the mandible. It is recommended that the order of tooth eruption in the mixed dentition age group be carefully evaluated.