Large complex odontomas associated with impacted mandibular second and third molars: a case report

Odontomas are the most common odontogenic tumors and are composed of dental tissues such as enamel, dentin and cementum. They are classified into compound and complex types. Compound odontomas usually appear as tooth-like structures in the anterior maxilla, whereas complex odontomas present as irregular masses of dental tissues, most frequently in the posterior mandible. Although odontomas are generally slow-growing and asymptomatic, large lesions can cause jaw expansion, facial asymmetry, and delayed tooth eruption. Various surgical approaches have been described, ranging from intraoral to extraoral incisions, with or without fixation.

In the present study, we present a 21-year-old Iranian woman with a large mandibular complex odontoma extending from the first molar to the ramus. The lesion was removed via an intraoral approach without pathological fracture or the need for fixation. At the 4-month follow-up, the patient experienced uneventful healing and no signs of recurrence.

This case highlights that even large mandibular odontomas can be managed intraorally without the need for fixation devices, with favorable short-term outcomes.