Radiographic incidental finding of a complex odontoma associated with mandibular third molar agenesis: a rare case report

Levi Natya Alus; Sylvia Agustin

doi:10.32793/jrdi.v10i1.1515

Authors

Levi Natya Alus Dental Medicine Program, Faculty of Dentistry, Universitas Mulawarman, Samarinda, Indonesia, 75119, Indonesia
Sylvia Agustin Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Universitas Mulawarman, Samarinda, Indonesia, 75119, Indonesia

DOI:

https://doi.org/10.32793/jrdi.v10i1.1515

Keywords:

Complex odontoma, third molar agenesis, mandible

Abstract

Objectives: This case report is aimed to report radiographic features of complex odontoma with mandibular third molar agenesis an incidental rare case.

Case Report: A 22-year-old female presented to the Dental Hospital Mulawarman University with a complaint of pain accompanied by tooth sensitivity in the maxillary molar. Extraoral clinical examination revealed no abnormal findings. Intraoral clinical examination showed a dental restoration on tooth 16. Radiographic findings revealed a radiopaque area suggestive of a restorative material, accompanied by a radiolucent lesion extending from the disto-occlusal region to the pulp chamber of tooth 16. Incidentally, an irregular, well-defined, corticated lesion was observed in the mandible region, associated with the absence of tooth 38. These findings were consistent with a complex odontoma occurring in conjunction with agenesis of the mandible third molar.

Conclusion: In this case, unilateral irregular round radiopaque well–defined corticated and the absence of third molar teeth in the mandible were found as the radiographic features that led to the suspect radiodiagnosis of a complex odontoma with agenesis of the third molar.

References

1. Ide F, Sakamoto S, Miyazaki Y, Nishimura M, Muramatsu T, Kikuchi K. Revisiting the History of Odontoma, with Special Reference to Its Original Illustration. Head Neck Pathol. 2023; 17(4): 976–83.

2. Ghoule G El, Salameh B, Manhal W El. Compound Odontoma : Diagnosis and treatment : Case report. Int Arab J Dent. 2023; 14(1): 91-8.

3. Decolibus KA, Rasner DS, Okhuaihesuyi O, Owosho AA. Clinicoradiopathologic Analysis of Odontomas : A Retrospective Study of 242 Cases. Dent J MDPI. 2023; 11(253): 1–12.

4. Shen Z, Wei J, Zhang J, Zhang Y, Yao J. The prevalence of dental agenesis, supernumerary teeth and odontoma in a Chinese paediatric population : an epidemiological study. BMC Oral Health. 2025; 25(458): 1–10.

5. Fauziah YA, Trisusanti R, Arifin FA, Khoironi E, Sarianoferni, Nasutianti H, et al. Radiologi Kedokteran Gigi. Purbalingga: Eureka Media Aksara; 2024. p. 1–185.

6. Kanchanasevee C, Chantarangsu S, Pittayapat P, Porntaveetus T. Patterns of nonsyndromic tooth agenesis and sexual dimorphism. BMC Oral Health. 2023; 23(37): 1–10.

7. Cavaré A, Decaup P hadrien, Boileau M josé, Garot E. Hypodontia as a predictor of third molar agenesis : A comparative cross-sectional study according to sex and tooth type in a French orthodontic population. Int Orthod. 2025; 23(3): 1–10.

8. Atarbashi-Moghadam S, Sadeghi TS, Shahrabi-Farahani S, Roghanizadeh L, Toghchi SG. Hybrid Odontogenic Lesions: A 30-year Retrospective Study. J Dent. 2025; 26(3): 199–209.

9. Alim N, Akhter F, Elhaddad S, Alasadi A, Alabudulwahab MN. Complex odontoma associated with an impacted upper central incisor : a case report and review of literature. J Med Case Reports BMC. 2025; 19(585): 1–9.

10. Muczkowska N, Czochrowska E, Mas?owska K, Wojtowicz A. Combined Surgical and Orthodontic Treatment of Complex Odontoma in Growing Patients : Presentation of Two Cases. MDPI. 2025; 13(82): 1–15.

11. Alhazmi YA. The Enigma Unveiled: Expansile Compound-complex Odontoma in the Anterior Maxilla of a Teenager. Int J Clin Pediatr Dent. 2024; 17(1): 82–5.

12. Kabilan S, Shah K, Landge J, Badhan T, Goyal P, Choudhary Y. Surgical treatment of complex odontoma in anterior maxilla – A rare case report. J Oral Med Oral Surgery, Oral Pathol Oral Radiol. 2023; 9(1): 61–4.

13. Gupta S, Mittal N, Shankari T, Gupta S. A rare incidence and management of complex odontoma and surgical dehiscence in maxillary anterior region: A case report. Natl J Maxillofac Surg. 2023; 14(1): 157–60.

14. Zalane M, Moulart C, Evrard L, Fallas J, Vilbi M, Dahdouh N. Atypical Location of a Complex Odontoma in an 11?Year?Old Girl: A Case Report With a 2?Year Follow?Up. Clin Case Reports. 2025; 13(11): 1–7.

15. Fallea A, Vinci M, Episcopo SL, Bartolone M, Musumeci A, Ragalmuto A, et al. Dissecting the Genetic Contribution of Tooth Agenesis. Int J Mol Sci MDPI. 2025; 26(10485): 1–24.

16. Johar HF, Erlina Y, Muttaqin GF. Multidisciplinary Approach to Complex Odontoma in Growing Individuals : Two Clinical Cases. Ann Orthod Periodontics Spec. 2025; 5(1): 63–74.

17. Antal G, Csabai L, Zsigmond A, Szanto I, Hadzsiev K. Heterogeneity of Orodental Features in a Family with Noonan Syndrome. Int J Mol Sci MDPI. 2025; 26(11414): 1–9.

18. Chiara R, Andrea M. Interdisciplinary Management of Large Odontomas in Growing Patients : Case Reports on Combined Surgical and Orthodontic Approaches. Int J Dent Res Allied Sci. 2025; 5(1): 124–31.

19. Chitara N, Rani D, Kanchan T, Krishan K. Odontoma and other congenital dental anomalies : Implications for forensic identification. Congenit Anomalies Wiley. 2023; 63(5): 132–40.

20. Lan R, Wu Y, Dai Q, Wang F. Gene mutations and chromosomal abnormalities in syndromes with tooth agenesis. Oral Dis Wiley. 2022; 10(2): 1–8.

21. Wredenhagen MS, Goldstein A, Mathieu H, Miranda V, Morali B, Santerre J, et al. The Quebec Dental Anomalies Registry : Identifying genes. PNAS Nexus. 2023;2(6):1–6.

22. Vinoth V, Annasamy RK, Krishnan R. Composite odontoma : An enigmatic impeder to the permanent teeth – Report of two cases with emphasis on molecular pathogenesis. Oral Oncol Reports Elsevier. 2024; 10(2): 1–4.

23. Dodamani AS, Sharma M, Gupta S, Singhal C. Giant Complex Odontoma of the Posterior Mandible : A Case Report. Cureus. 2024; 16(9): 1–5.

24. Chen J, Ying Y, Li H, Sha Z, Lin J, Wu Y, et al. Abnormal dental follicle cells : A crucial determinant in tooth eruption disorders (Review). Spandidos Publ. 2024; 30(168): 1–19.

25. Singh HP, Chahal GK, Sharma G, Gandhi P. A systematic review on odontogenic cysts and tumours. J Oral Maxillofac Pathol. 2024; 28(2): 268–74.

26. Kanavakis G, Alamoudi R, Oeschger ES, Tacchi M, Halazonetis D, Gkantidis N. Third molar agenesis relates to human craniofacial form. Eur J Orthod. 2024; 46(1): 1–9.

27. Tokavanich N, Wein MN, English JD, Ono N, Ono W. The Role of Wnt Signaling in Postnatal Tooth Root Development. Front Dent Med. 2021; 2(1): 1–13.

28. Polti LF, Felix FA, Souza MS. The WNT/?-catenin signaling in the context of odontogenic cysts and tumors : an update. J Oral Diagnosis. 2025; 10(1): 1–10.

29. Apablaza JA, Munoz G, Arriagada C, Bucchi C, Masuko TS, Fuentes R. Odontoma Recurrence. The Importance of Radiographic Controls : Case Report with a 7-Year Follow-Up. Medicina (B Aires). 2024; 60(8): 1–11.

30. Zuccon A. Management of Complex Odontoma in Pediatric Patients Using a Combined Surgical and Orthodontic Approach : Report of Two Cases. Ann Orthod Periodontics Spec. 2024; 4(1): 67–78.