Erupted rootless type III dense in dente (dilated odontoma) masquerading as peripheral gingival pathosis

Abstract

Dense in dente, also known as dense invaginatus or dilated odontoma, is a developed malformed tooth and usually does not pose a diagnostic challenge. Described here is a unique case in which a rootless type III dense in dente (dilated odontoma) between the lower deciduous molars in a 2-year-old girl emerged through the gingiva mimicking a peripheral developing odontoma. At the time of examination, neither anchored in bone nor associated with an underlying un-erupted tooth. The small size, the superficial position in the growing mandible, the absence of the overlying bone and the physiologic eruptive movement of the neighbouring teeth may predispose the present rootless dense in dente to erupt in the gingiva.

An Erupted Dilated Odontoma: A Rare Presentation

“…The above case is unique as the patient also had hyperdontia and there was the presence of a dilated odontoma in an erupted tooth in anterior maxillary region. However, there is no description of an erupted dilated odontoma [ 6 , 7 ]. Most of dilated odontoma cases have been reported from the posterior mandibular areas and have been impacted frequently.…”

Peripheral developing odontoma: Is it so rare?

“…Nevertheless, there is confusion and controversy in the current literature regarding the integration or segregation of these two distinct entities (PDO vs EO; Supporting Information S5). 3,4 Finally, da Silva Rocha et al 1 included a case of Sfakianou et al 5 as PDO, but in our opinion, this may be an example of natal/neonatal tooth‐related continued growth of the dental papilla (Supporting Information S6).…”

“…There are many reports of cases in which during progressive eruption, the tooth pushed a pericoronal small compound odontoma (cluster of miniature cone‐shaped supernumerary teeth) peripherally, thus deceptively mimicking EO (denticles in the dentogingival complex; Supporting Information S4). In view of its very limited growth potential (usually undergoing involution), it is difficult to accept that, with time, early PDO would normally mature into well‐formed denticles and eventually erupt 3 . Nevertheless, there is confusion and controversy in the current literature regarding the integration or segregation of these two distinct entities (PDO vs EO; Supporting Information S5).…”

“…To our knowledge, after the first complete description by Grodjesk 2 in 1953, other unequivocal examples of PDO have been reported worldwide (Supporting Information S1). 3,4 Depending on the stage of histodifferentiation evident at surgery and in view of the presence of ghost cells in many of the lesions, a variety of names have been suggested 4 . It is known that PDO is an interesting lesion that has been well illustrated and commented on in both standard texts (Supporting Information S2) and the literature (Supporting Information S3).…”