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Intra-osseous carcinomas of the jaw are rare tumours, thought to arise from residual elements of the odontogenic epithelium. We report an additional case which, unusually, was characterised by marked osseous metaplasia. We propose that the new bone formed around the tumour is the result of an epithelial-mesenchymal interaction between malignant odontogenic epithelium and osteogenic precursor cells in the surrounding stroma.

A case is presented of a 25-year-old man with a submerged lower second deciduous molar and an impacted lower second premolar. Treatment was complicated by the relationship of the teeth to the inferior dental nerve, which necessitated extensive bone removal and mental nerve transposition to remove the submerged and impacted teeth. Early recognition and treatment of the submerging tooth might have prevented the need for such extensive surgery and morbidity at a later date.