Rare story!

A 17-year old boy, Ashik Gavai, born in a family of cotton growers near Mumbai underwent a six hours long dental operation at JJ Hospital in Mumbai to remove 232 teeth which had grown as a result of a rare condition called composite odontoma.

He had a benign tumour in his mouth which caused one molar tooth to grow hundreds of additional smaller teeth. Gavai, residing in an area outside of Mumbai, had experienced lot of swelling along his jaw which his parents feared to be related to cancer.  Doctors at JJ Hospital used surgical method of ‘chisel and hammer’ to remove the extra teeth one by one. Now Ashik has only 28 teeth like most young people of his age.

Odontoma is a rare developmental anomaly characterized by the growth of tumours occurring due to the differential growth of epithelial and mesenchymal cells. These tumours are formed of enamel, dentin, cementum and pulp tissue.

Odontoma was first named by a French physician and surgeon, Paul Broca, in 1867. Broca defined Odontoma as tumours formed by the overgrowth of transitory or complete dental tissues and arise during the normal tooth development. These tumours known as ameloblasts or odontoblasts are though anatomically similar to the normal teeth but are irregular and disordered.

Another 11-years-old female patient was also diagnosed with Composite Odontoma at the Department of Pedodontics and Preventive Dentistry, VS Dental College and Hospital, Bangalore. She primarily complained of a non eruption of a front tooth on upper right side while the opposite tooth has already erupted. There was no facial asymmetry, pain, inflammation, swelling or overlying mucosa.

Oral examination using radiographic techniques revealed a hard tooth-like mass obstructing the eruption of the concerned teeth. On further examination a collection of tooth-like structures with a surrounding band and a smooth outer area were revealed. These were also removed via surgical procedure.

Odontoma may occur due to local trauma, infection or genetic factors. Odontoma may occur in the bone or soft tissue. It may or may not erupt into the oral cavity. Most cases of Odontoma do not show any symptoms and just very few cases may exhibit swelling, delayed eruption, missing teeth or infection. The neighbouring teeth may also show signs of malformation, demineralisation or malposition etc. Canines, upper central incisors and third molars are most commonly affected by odontomas.

The treatment methods for Odontoma vary case to case. Surgical removal, extraction, fenestration and traction of the affected tooth can be done depending on the nature of Odontoma. It is very critical to detect and treat Odontoma well in time because these tooth-like structures may cause further complications such as cystic changes, tooth loss, expansion of bone and interference with eruption of tooth.

Image source: brimtime.com

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