Surgical Treatment of a Compound Odontoma in Chow Puppy

A 10 month old Chow Mix presented to Arizona Veterinary Dental Specialists for evaluation and treatment of an oral mass affecting the right maxilla in the region of the canine tooth. The canine tooth was not present on visual examination, however, numerous small tooth-like structures were observed protruding through the gingiva in this region. The owner reported an accident involving part of a couch landing on his head when he was a young puppy, but that this accident did not appear to result in any significant injury.

An anesthetized oral examination was performed and intraoral radiographs were obtained. Radiographs revealed the presence of an unerupted canine tooth and numerous “denticles”, which are considered a pathogneumonic sign for the compound odontoma. No other oral pathology was identified.

Pre-surgical radiograph revealing numerous denticles and the unerupted canine tooth.

Pre-surgical radiograph revealing numerous denticles and the unerupted canine tooth.

A gingival flap was created to expose the entire odontoma and unerupted canine tooth. As is often found, connective tissue was present around the denticles and unerupted tooth. This allowed the mass to be excised largely whole via use of a high speed drill and periosteal elevator. This was done in a cautious manner to avoid surgical trauma to the nasal passage. Postoperative intraoral radiographs were obtained to confirm removal of all denticles, and curettage was performed to remove any grossly evident connective tissue previously associated with the odontoma. The gingival flap was closed without tension and the patient recovered from anesthesia without complication.

Odontomas are found in a variety of species and are the most common odontogenic tumor type in humans. There are two types of odontomas: compound and complex. Both types are considered uncommon in non-human species, and are often diagnosed in dogs between 8 and 18 months of age. It is hypothesized that these tumors may be caused in part by oral trauma, and they are often associated with unerupted teeth. While compound odontomas are characterized by the presence of denticles, the complex odontoma is a radio-opaque amorphous mass without denticles. Both tumor types are benign and can usually be managed via surgical excision with a low likelihood of recurrence.