Title: Compound odontoma and anterior maxillary retention the value of a conservative approach
Abstract:
Introduction : Retention of maxillary central and lateral incisors is uncommon and may lead to significant esthetic and functional issues. It is often associated with eruptive obstacles such as compound odontomas or prior trauma. Accurate diagnosis, localization of the impacted teeth, and evaluation of their eruptive potential are essential for treatment planning. When conditions are favorable, simple removal of the obstacle may allow spontaneous eruption.
Materials and Methods : We report the case of a 10-year-old patient referred for retention of teeth 11, 12, 13, and 53 due to a compound odontoma associated with a cystic lesion. Surgical removal of the odontoma and cyst was performed without extracting the primary incisors, in order to preserve the natural eruption pathway. The patient was followed clinically and radiographically at regular intervals. Upon confirmation of progressive eruption of the permanent teeth, the retained primary teeth were extracted. A pediatric prosthesis was fabricated in collaboration with the orthodontic department for esthetic and functional purposes.
Results : Teeth 11, 12, and 13 erupted spontaneously without orthodontic traction. Tooth 53 remained impacted and was extracted later, after the complete eruption of the permanent teeth.
Discussion : Anterior maxillary tooth retention presents both diagnostic and therapeutic challenges. Compound odontomas are a common cause of eruption failure. This case highlights the value of early diagnosis, conservative management, and close interdisciplinary follow-up to promote spontaneous eruption and minimize invasive procedures.
Conclusion : A tailored, stepwise, and multidisciplinary approach is essential to ensure favorable outcomes in cases of odontoma-related tooth retention.
