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SCS-17-0461
BRIEF CLINICAL STUDIES
Immediate Dental Implant
Placement After Removal of
Complex Odontoma
Fábio Roberto de Souza Batista, DDS,
Victor Eduardo de Souza Batista, DDS, MSc,y
Aljomar José Vechiato-Filho, DDS, MSc, PhD,z
Victor Tieghi Neto, DDS, MSc,§
Jéssica Araújo Figueira, DDS,jj
and Fellippo Ramos Verri, DDS, PhDy
Abstract: The aim of the authors was to report a clinical case about
immediate implant placement after the removal of complex odon-
toma. A 35-year-old female patient presented to private service
complaining about absence of lower right first premolar. The
computed tomographic showed radiopaque attenuation, surrounded
by a narrow radiolucency in the area of dental absence, suggesting a
mineralized lesion. The surgical removal of lesion was performed
by intraoral access with general anesthesia and the implant of
3.75  10 mm (Neodent) was placed with the aid of a surgical
guide, following the drill sequence established by the manufacturer.
No complications were observed after 1 year with the prosthetic
rehabilitation.
Key Words: Dental implants, dental prosthesis, implant-
supported, odontoma
dontoma is one of the most common odontogenic tumors.1
O They are classified into complex and compound.1,2 Basi-
cally, complex odontoma forms amorphous calcification, with
dysplastic dentin covered by enamel, whereas the compound
odontoma forms multiple irregular toothlike structures.1,2 As a
complication, this lesion may cause the retention of primary teeth
and the noneruption of permanent teeth. In this context, dental
implants have been used for the treatment of partial and total
edentulous showing high success rate in different situations.3 – 6
Although there are studies about immediate implant placement
after tooth extraction,7 no report is found after the removal of
complex odontoma. Thus, the aim of the authors was to report a
clinical case about immediate implant placement after the removal
of complex odontoma.
From the Department of Surgery and Integrated Clinic; yDepartment of
Dental Materials and Prosthodontics, Araçatuba Dental School—Univ
Estadual Paulista Júlio de Mesquita Filho Araçatuba—UNESP Ara-
çatuba; zCancer Institute of Sao Paulo State (ICESP); §Department of
Stomatology, Bauru School of Dentistry, University of São Paulo,
Bauru; and jjDepartment of Pathology and Clinical Propedeutics, Ara-
çatuba Dental School—Univ Estadual Paulista Júlio de Mesquita Filho
Araçatuba—UNESP Araçatuba, Brazil.
Received March 11, 2017.
Accepted for publication April 7, 2017.
Address correspondence and reprint requests to Victor Eduardo de Souza
Batista, DDS, MSc, Department of Dental Materials and Prosthodon-
tics, UNESP—Univ Estadual Paulista, José Bonifácio St, 1193,
Araçatuba, São Paulo 16015-050, Brazil;
E-mail: victor_edsb@hotmail.com4
The authors report no conflicts of interest.
Copyright # 2017 by Mutaz B. Habal, MD
ISSN: 1049-2275
DOI: 10.1097/SCS.0000000000003885
The Journal of Craniofacial Surgery  Volume 00, Number 00, Month 2017
Copyright © 2017 Mutaz B. Habal, MD. Unauthorized reproduction of this article is prohibited.
FIGURE 1. (A) Computed tomographic. (B) Intraoral access. (C) Cavity after the
surgical access. (D–F) Removal of the lesion. (G) Anorganic bovine bone onto
the surgical cavity. (H) Suture. (I) Periapical radiograph after 7 days. (J) Periapical
radiograph after 8 months. (K) Control of 1 year of the prosthetic rehabilitation.
(L) Periapical radiograph after 1 year of the prosthetic rehabilitation.
A 35-year-old female patient presented to private service com-
plaining about absence of lower right first premolar. The intraoral
examination revealed the absence of the lower right first premolar.
The computed tomographic showed radiopaque attenuation, sur-
rounded by a narrow radiolucency in the area of dental absence
(Fig. 1A), suggesting a mineralized lesion.
The surgical removal of lesion was performed by intraoral
access with general anesthesia (Fig. 1B). The lesion was accessed
by ostectomy of buccal cortical (Fig. 1C); then, it was fully removed
by several sections (Fig. 1D–F). Macroscopically, the clinical
aspect of the lesion showed characteristics of mineralized tissue.
After the surgical removal of lesion, the implant of 3.75  10 mm
(Neodent) was placed with the aid of a surgical guide, following the
drill sequence established by the manufacturer. Then, the anorganic
bovine bone (Bio-Oss) (Fig. 1G) associated with bovine collagen
membrane was used to fill the surgical cavity and the suture was
performed (Fig. 1H). Tissue collected was sent for histopathologic
analysis, which exhibited compatibility with complex odontoma.
The patient was examined after 7 days, 15 days 1 month and
8 months after the operation (Fig. 1I and J). No significant regrowth
of the lesion was noted. In this examination it was possible to
observe the complete osseointegration of the implant and the patient
was forwarded to prosthetic rehabilitation (Fig. 1K and L). No
complications were observed after 1 year with the prosthetic
rehabilitation.
The authors believe that to place the implant immediately after
removal the lesion is a viable treatment, since the complex odon-
toma is an uncontaminated lesion. Furthermore, the patient can be
rehabilitated with dental implant in a unique surgical stage decreas-
ing the time of treatment.
REFERENCES
1. Sun L, Sun Z, Ma X. Multiple complex odontoma of the maxilla and the
mandible. Oral Surg Oral Med Oral Pathol Oral Radiol 2015;120:e11–
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2. Ferreira PH, Ferreira S, Faverani LP, et al. Compound odontoma in a
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3. Malmstrom H, Gupta B, Ghanem A, et al. Success rate of short dental
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4. Tealdo T, Menini M, Bevilacqua M, et al. Immediate versus delayed
loading of dental implants in edentulous patients’ maxillae: a 6-year
prospective study. Int J Prosthodont 2014;27:207–214
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Brief Clinical Studies The Journal of Craniofacial Surgery  Volume 00, Number 00, Month 2017

5. de Souza Batista VE, Ferreira JP, Santiago JF Jr et al. Existence of and
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2 # 2017 Mutaz B. Habal, MD

Copyright © 2017 Mutaz B. Habal, MD. Unauthorized reproduction of this article is prohibited.