Male patient, 32 years old, presented to the Stomatology Service of the Bauru School of Dentistry, University of São Paulo, complaining of "tooth within the bone" routine radiographic examination.
Clinically, it was observed that tooth 83 was present within the dental arch and tooth 43 was absent.
An asymptomatic increase in bone size was confirmed, with an evolution of approximately five years, extending from the region of tooth 32 to tooth 44.
In the visualization of the panoramic radiographic examination, a radiolucent alteration of well-defined limits was detected with radiopaque amorphous material in the center, with lobular appearance, absence of root resorption of adjacent teeth 43.
The presumptive diagnosis was complex odontoma.
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Under local anesthesia, access was performed through an intra-south incision extending from the region of teeth 34 to the consequent exposure of the lesion through the constant osseous irrigation window surgical burr.
The lesion was removed by enucleation with aggressive curettage along with unerupted 43 tooth.
Microscopic sections proliferation of odontogenic epithelial cells in close contact with numerous rounded foci of compatible mineralization revealed eosinophilic basophils, sometimes resulting in eosinophilic appearance.
The cells presented well evident intercellular bridges, in addition to pleomorphism, hyperchromatism and variation in relation to the size of the nuclei.
In fibrous connective tissue, cords or islands of odontogenic epithelium were observed.
The histopathological diagnosis was TEOC.
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The radiographic examination of five years of follow-up shows the absence of signs of recurrence of the lesion.
