Odontomas represent the most prevalent type of odontogenic tumors worldwide. While these lesions usually grow slowly and remain asymptomatic, large variants can cause significant facial asymmetry and jaw expansion. Consequently, achieving effective complex odontoma surgical management is vital for preventing long-term complications like pathological fractures or tooth impaction.

In a recent clinical report, a 21-year-old Iranian woman presented with a substantial mandibular lesion. Specifically, the growth extended from the first molar area to the ramus. This large mass accompanied impacted second and third molars, necessitating a careful surgical plan. Clinicians often choose between intraoral and extraoral access depending on the lesion's size and proximity to vital structures.

Advantages of Intraoral Complex Odontoma Surgical Management

Choosing an intraoral approach offers several benefits, especially for large mandibular lesions. For instance, this method prevents external scarring and reduces the risk of damaging the facial nerve. In this case, the surgeons successfully removed the entire irregular mass without causing a pathological fracture. Furthermore, they did not require any internal fixation devices despite the lesion's extent. The patient experienced uneventful healing and showed no signs of recurrence at the four-month follow-up visit. Therefore, surgeons can often manage even extensive mandibular tumors conservatively through the oral cavity.

Frequently Asked Questions

How do complex and compound odontomas differ?

Compound odontomas consist of multiple small, tooth-like structures and typically appear in the anterior maxilla. Conversely, complex odontomas form irregular, unorganized masses of dental tissue and most frequently occur in the posterior mandible.

When is an extraoral approach necessary for odontoma removal?

Surgeons might consider an extraoral approach for extremely large lesions that involve a high risk of jaw fracture or those positioned deep within the ramus. However, as this case illustrates, many large lesions remain accessible through an intraoral incision if the remaining cortical bone is stable.

Disclaimer: This content is for informational and educational purposes only. It does not constitute medical advice or establish a doctor-patient relationship. Refer to the latest local and national guidelines for clinical practice.

References

1. Babadi E et al. Large complex odontomas associated with impacted mandibular second and third molars: a case report. J Med Case Rep. 2026 Jun 06. doi: 10.1186/s13256-026-06166-w. PMID: 42251457.


2. Lone P, Kour I, Gandral A. Intra Oral Approach for Complex & Compound Odontomas (Large or Small). Modern Plastic Surgery. 2014;4:35-45.


3. Akbulut N. Huge Complex Odontomas in Two Cases with Unique History and Treatment Protocols. Clinics in Surgery. 2018;3:1898.