mandibular odontoma

Re: mandibular odontoma

Rob Davis — Sat, 22 Mar 2014 08:40:37 GMT

What an interesting case! If you do attempt surgery it would be great if you could get some photographs to post, and let us know how it goes.

Re: mandibular odontoma

Evelyn Barbour-Hill — Fri, 21 Mar 2014 01:13:04 GMT

[quote user="derrick carpenter"]Have you seen one this large before? [/quote]

No. It's a humdinger.

All the more satisfying to treat!

Re: mandibular odontoma

Peter Southerden — Fri, 21 Mar 2014 00:11:51 GMT

What an interesting case! It would be good to see the histology report though radiographically it does look typical of a complex odontoma.

Surgical treatment will be challenging as though the excision from within the thin bony capsule of the mandible will be relatively straight forward, it becomes more difficult to determine the limit of the abnormal tissue where it has broken through the cortex and is sitting beneath the oral mucosa. In these regions I would aim to take a small margin of healthy tissue.

The prognosis is good but I agree with Evelyn that it is not certain. I think that intracapsular/marginal excision is likely to be better than rostral mandibulectomy as it is much more conservative.

I have seen and treated a similar case that did very well.

Re: mandibular odontoma

derrick carpenter — Thu, 20 Mar 2014 21:55:57 GMT

Have you seen one this large before? This is the first one I've seen

Re: mandibular odontoma

Evelyn Barbour-Hill — Thu, 20 Mar 2014 21:22:24 GMT

Never guarantee that anything will be curative. I suppose, to be fair, that most clients who ask for this are just trying to get things straight in their own minds, but a few will be back very angry indeed if anything goes wrong. "But you said that this operation would be a cure!"

Go for scooping out. Constant copious irrigation with cold saline and judicious use of swabs should deal with the blood. As for the risk of fracture, I bet it will be all right if you go carefully; and if it does fracture, it will heal fine, maybe with no surgical treatment at all.

(Or refer?)

PS. Do you have complete trust in your pathologist?