Three-dimensional imaging characteristics of odontomas using cone-beam computed tomography: a clinical retrospective study

Cone-beam computed tomography (CBCT) enables high-resolution three-dimensional (3D) visualization of odontoma morphology. However, a standardized CBCT-based morphological subtyping system remains lacking, and its association with clinical anomalies such as impacted teeth remains unclear. Therefore, the aim of this study was to establish this morphological subtyping system via 3D feature characterization and explore its correlations with clinical anomalies.

A retrospective analysis was conducted on 52 histopathologically confirmed cases of odontoma, treated between 2023 and 2025 at the Affiliated Stomatological Hospital, Southwest Medical University. The CBCT assessments captured lesion location (central, labial/buccal, or lingual/palatal), pathological type (compound or complex), morphological subtype (I-IV), and associated dental anomalies. Statistical analyses were conducted using SPSS v26.0, with the significance level set at α = 0.05.

Odontomas were predominantly located in the anterior dental region (63.5%), showing a significantly higher incidence than in the premolar (21.1%) and molar regions (15.4%) (χ² = 18.93, p = 0.003). Commonly associated anomalies included impacted teeth (76.9%), retained deciduous teeth (50.0%), and mild jaw expansion (50.0%). Morphological subtypes I, II, and III collectively accounted for 90.4% cases, constituting the major clinical morphological subtypes.

This study established a structured CBCT-based 3D morphological subtyping system for odontomas that was validated against histopathology and correlated with clinical features. This system clarifies the epidemiological patterns of odontomas and their associations with dental anomalies, and may serve as a potential reference for preoperative assessment; though, its clinical applicability requires further investigation.