Objectives. Odontomas are the most common odontogenic tumors of the oral cavity. They account for 22-67% of all
maxillary tumors with an increased prevalence in children and adolescents. They are asymptomatic and are generally
diagnosed by radiographic examination. The chosen treatment is surgical excision of the lesion followed by a histo-
pathological examination.
The aim of this study is to show confocal laser scanning microscopic features in a case of compound odontoma not
easily evident when using an optical traditional microscopy.
Methods. A case of bilateral mandibular compound odontoma in young patient is presented. Radiographic analysis
revealed two symmetrical radio-opaque masses with a surrounding thin radio-transparent halo, up to the first lower
premolars. Surgical excision of the lesion under general anesthesia was performed. The specimens were fixed in a
buffered solution of 10% formalin, embedded in paraffin, cut in 3 μm thick serial sections, stained with hematoxylineosin,
observed by optical microscope and by Confocal Laser Scanning Microscope (CLSM).
Results. Control at 2 weeks showed excellent healing of the tissues. Follow-up at 6 months showed the absence of recurrence
and the eruption of the previously retained teeth. CLSM analysis in autofluorescence underlined a different fluorescence
of soft and hard tissues showing different intensity of emission in autofluorescence due to different degrees
of calcification. The odontogenetic components appeared strongly autofluorescent and presented foci of ectomesenchymal
dentinogenetic multifocal differentiation that cause irregularities in the shape and structure of the tissue.
Conclusions. Odontomas are frequent in childhood and are often responsible for dental retention. CLSM allows a
careful histo-morphological analysis of odontomas and other odontogenic tumors. The morpho-structural organization
of the cellular component is also observed with the possibility of three-dimensional reconstruction.
References
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2009; 40(1):61-72.
• Tamme T, Soots M, Kulla A, Karu K, Hanstein S-M, Sokk A, et al. Odontogenic tumours, a collaborative retrospective study of
75 cases covering more than 25 years from Estonia. J Cranio-Maxillofacial Surgery 2004; 32:161-5
