855 Mirror-Image Large Complex Odontomes

Abstract Background This report outlines a nine-year follow-up of two 10-year-old patients who attended the paediatric dental department reporting an absent mandibular first permanent molar (FPM). Both reported no pain, familial history hypodontia and altered sensation in inferior (ID) nerve distribution. Clinical examination revealed expansion unerupted tooth area. Special Investigations Panoramic jaw radiographs extensive radio-opaque masses FPM area both children, mirror-image sites. Subsequent cone beam CT identified displacement with associated large mixed radiopaque/radiolucent lesion body mandible. Interestingly, second (SPM) was present one case other. Diagnosis/Management The provisional diagnosis for cases complex odontome however, heavily calcified ameloblastic fibro-odontoma could not be excluded. Management involved surgical removal odontogenic tumour maintenance. Histopathology confirmed odontoma cases. On long-term review failed to erupt. Cystic follicular enlargement prevented eruption, coronectomy performed other on apices were too close ID extracted. Discussion These highlight importance monitoring eruption patterns childhood. Despite mirror image diagnosis, multiple factors considered when identifying treatment options each individual patient. Aetiological questions regarding this particular type are raised by presence or absence SPM.