Bilateral Massive Complex Composite Odontoma of the Mandible: A Rare Case Report

RATIONALE: Odontomas result from abnormal growth of differentiated epithelial and mesenchymal cells, which form ameloblasts and odontoblasts along with pulp tissue at times. PATIENT CONCERNS: A patient reported with a chief complaint of hard swelling of the lower jaw causing difficulty in mouth opening and facial deformity. DIAGNOSIS: A provisional diagnosis of complex odontome based on clinicoradiological findings was made, which was later confirmed as complex composite odontome histologically. TREATMENT: Bilateral hard tissue mass was surgically removed from the mandible with utmost precaution to prevent jaw deformity. On fine separation, the specimen yielded nearly 82 small teeth-like structures. OUTCOMES: Histopathologically, multiple small teeth-like structures with haphazardly arranged central fibrofatty pulpal stroma surrounded by well-formed dentinal tubules and empty areas representing decalcified enamel matrix surrounded by fibrovascular stroma at the periphery were seen. TAKE-AWAY LESSONS: Early diagnosis and treatment ensures minimal surrounding deformities, better prognosis, and less chances of recurrence.