Jerry E Bouquot¹*, Melissa Luna², Brett Barnette³ and Yassmin AM Mohamed⁴

¹Clinical Professor and Past Chair of Oral Pathology, Department of Oral and Maxillofacial Surgery, School of Dentistry, West Virginia University, Morgantown, West Virginia
²Assistant Professor, Director of Maxillofacial Diagnostics, Department of Oral and Maxillofacial Surgery, School of Dentistry, West Virginia University, Morgantown, West Virginia
³Resident, Department of Oral and Maxillofacial Surgery, School of Dentistry, West Virginia University, Morgantown, West Virginia
⁴Lecturer, School of Dentistry, University of Khartoum, Khartoum, Sudan

*Corresponding Author: Jerry E Bouquot, Clinical Professor and Past Chair of Oral Pathology, Department of Oral and Maxillofacial Surgery, School of Dentistry, West Virginia University, Morgantown, West Virginia.

Received: July 25, 2025; Published: August 11, 2025

Abstract

Background: The odontoma is the most common of all odontogenic tumors but one of its variants, the cystic odontoma, is so infre quent that it is typically not even mentioned in published reports and reviews of odontomas. We present what we believe to be the first “true” cystic odontoma, defined as a compound or complex odontoma surrounded entirely by its own epithelium-lined cystic sac, essentially found within a fluid-filled cystic lumen, with no associated impacted tooth and no attachment of the cyst lining to the inner structures. We suggest that the term cystic odontoma be reserved only for this type of odontoma, and that the descriptive term “dentigerous cyst with embedded odontoma” be used for those entities comprised of odontomas in the stroma of a cyst. We present herein a detailed account of the first true cystic odontoma, with a brief review of a second one from our files.

Case Reports: A 19-year-old male presenting with an asymptomatic, slowly enlarging cortical expansion of the facial aspect of the right maxillary incisor region. No unerupted teeth were in the area and the lesion had slightly rotated both right incisors. Radio graphs showed a 19x14 mm well-demarcated mixed radiopaque/radiolucent lesion with an even, thin sclerotic rim surrounding an irregular zone of radiolucency. Diminutive tooth-like structures could be seen. At surgery a lobulated mass was seen to be completely covered by a thin, semitranslucent membrane. The lesion shelled out easily and the surface membrane peeled away completely, with no attachment to underlying structures. Microscopically, the outer capsule was similar to a dental follicle, with a cuboidal epithelial layer overlying dense fibrous tissue and facing a centrally located mass of small, often mature teeth with areas of immature or embry onic dental tissues in a fibrous background. There was no recurrence. An additional cystic odontoma from our files was located in the anterior maxillary midline of a 16-year-old female. It was asymptomatic and non-expansile and 11 x 11 mm in radiographic diameter; it proved to be a composite odontoma “floating” in a clear fluid, surrounded by an epithelial-lined cyst.

Conclusions: We present the first reported example of a true cystic odontoma: an odontoma completely surrounded by a follicle like cyst lining. The calcified portion of the odontoma, in this case a combination of compound and complex odontomas, was located within a fluid-filled cystic lumen; there was no associated impacted tooth. The odontoma shelled out easily and did not recur.

Keywords:Cystic Odontoma; Odontoma; Odontogenic Tumors

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Citation

Citation: Jerry E Bouquot., et al. “A New Lesion? A True Cystic Odontoma, Completely Enclosed within Its Own “Dental Follicle”".Acta Scientific Dental Sciences 9.9 (2025): 13-19.

Copyright

Copyright: © 2025 Jerry E Bouquot., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.