The usefulness of cone beam computed tomography for treatment of complex odontoma

Odontomas are odontogenic tumours, resulting from epithelial growth and differentiated mesenchymal cells, clinically asymptomatic, and often associated with changes to the eruption of the permanent dentition. In recent years, cone beam computed tomography (CBCT) has been used in the diagnosis and treatment planning of this condition.

A 9-year-old male patient, with an unerupted permanent maxillary right central incisor (tooth 11) presented to our clinic. The panoramic radiograph showed impaction of tooth 11 with incomplete root development and the suspicion of an odontome and supernumerary tooth. CBCT was performed and enabled the visualisation of a radiopaque image compatible with an odontome, confirming the presence of an impacted supernumerary tooth on the palatal surface of tooth 11.

Surgical excision of the odontome and the supernumerary tooth was performed.

Clinical and radiographic evaluations 2 months after the removal of the lesion showed lack of space for the eruption of tooth 11. The patient was referred for orthodontic treatment and a Hyrax appliance was fitted. The patient has been followed for 12 months.

CBCT is an important auxiliary tool, aiding in both correct diagnosis and accurate treatment planning. It is currently a technology accessible to most paediatric dentists and should be beneficial considering the diagnostic information provided as well as the cost-benefit ratio for the patient.