Oral and Maxillofacial Surgery

, Volume 14, Issue 4, pp 247–252 | Cite as

Two-stage surgical removal of large complex odontoma

  • Bruno Ramos Chrcanovic
  • Filipe Jaeger
  • Belini Freire-Maia
Case Report



The surgical treatment of a large complex odontoma in the mandibular angle is reported. Four possible surgical approaches to remove a benign tumor in the mandibular angle are discussed.


A two-stage surgical treatment was chosen; first, removing most part of the lesion and preserving the second molar, decreasing the risk of a pathological mandibular fracture. A maxillo-mandibular fixation for a period of 4 weeks was used. The patient was oriented to maintain a soft diet. The second surgical stage occurred 3 months after the first one due to the significant bone consolidation observed, reducing the possibility of a mandibular fracture. The remaining lesion and the second molar were then completely removed.


This case demonstrates the value of the tridimensional computed tomography in treatment planning prior to any definitive surgery. A computed tomography should be made in every case of intraosseous lesion in order to establish the intraosseous extent of the tumor, cortical perforation, and soft tissue involvement for precise guidance for the surgical planning. It is recommended that the surgeon considers excision by an intraoral, lingual approach when indicated, and in two stages, when an extremely thin mandibular base is present.


Odontogenic tumors Complex odontoma Computed tomography 


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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Bruno Ramos Chrcanovic
    • 1
  • Filipe Jaeger
    • 2
  • Belini Freire-Maia
    • 3
    • 4
  1. 1.Belo Horizonte, MG-CEPBrazil
  2. 2.Nova LimaBrazil
  3. 3.Belo Horizonte, MG-CEPBrazil
  4. 4.Department of Oral and Maxillofacial Surgery, School of DentistryPontifícia Universidade Católica de Minas GeraisBelo HorizonteBrazil

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