Compound odontoma and impaction of the lower left deciduous canine in a 4-year-old child: diagnosis and treatment

Background: Odontomas are the most common odontogenic tumours, often considered hamartomas rather than true neoplasms. These mixed tumours consist of fully differentiated dental tissues, including enamel, dentin, cementum, and pulp. Odontomas can be classified into compound and complex types. While typically asymptomatic, they are often discovered during routine radiographic examinations for delayed tooth eruption. The management of odontomas generally involves surgical removal, which is effective in resolving associated dental impactions. Case report: We present the case of a healthy 4-year-old child who presented with the absence of the lower left deciduous canine (tooth 7.3) in the dental arch. Radiographic examination revealed multiple radiopaque masses indicative of a compound odontoma associated with the unerupted deciduous canine. Following detailed imaging and surgical planning, the odontoma was successfully enucleated under conscious sedation with nitrous oxide. The surgical procedure was performed without extracting the retained canine. Post-operative follow-up at two weeks showed excellent healing, and at seven months, partial eruption of the canine was observed, confirming the odontoma's role in impeding its eruption. Conclusion: This case underscores the importance of early diagnosis and management of odontomas to prevent potential impaction of associated teeth. The successful surgical removal of the odontoma facilitated the spontaneous eruption of the lower left deciduous canine, highlighting the effectiveness of early intervention. Conscious sedation with nitrous oxide proved to be a valuable tool in managing the young patient, ensuring cooperation and comfort during the procedure. Early identification and treatment of odontomas are crucial for promoting normal dental development and preventing future malocclusions.