Case report of a dilated odontome in the posterior mandible

Dens invaginatus (dens in dente) is a developmental malformation resulting from an invagination of enamel organ into the dental papilla, beginning at the crown and sometimes extending into the root before calcification occurs. Dilated odontome is the most extreme form of dens invaginatus and it is extremely rare in the posterior mandible.

A 47 years old female patient with occasional episodes of diffuse pain and discomfort in the left posterior mandibular region. The extra-oral examination showed slight facial asymmetry. Panoramic and intra-oral X-rays show an intraosseous circular formation with radiopaque external limits and radiolucent interior.

Computerized tomography scan reveals the bone integrity around the formation, as well as the independence of the neuro-vascular structures of the region. The most likely diagnostic option was dilated odontome. The enucleation procedure was carried out, and the fragments were sent to histopathological examination that revealed a diagnosis consistent with a dilated odontome.

In this case, the conservative surgical approach after planning was effective and predictable in the treatment of the pathology and patient symptoms without major complications.