Dental Tribune India

Oral surgeons in Saveetha Dental College, Chennai extract 526 teeth from a single site in a child.

By Dental Tribune South Asia
August 12, 2019

CHENNAI, India: In a 2-hour long surgery, performed at the Saveetha Dental College and Hospital, the Oral and Maxillofacial Surgeons have successfully removed 526 teeth from a single site in a 7-year-old boy's mouth. The operating surgeon removed a well-defined bag like mass in its entirety, instead of exploring it on the operating table (akin to opening a bag of worms) which could have extended the duration of general anaesthesia unnecessarily.

A 7-year-old boy was brought to Saveetha Dental College and Hospital by his parents for a swelling he had developed in his lower jaw. Earlier, he had been taken to another hospital in Chennai after his parents noticed a small swelling for the first time, but he had refused to co-operate for any investigations as he was just 3 years old then. Thus the swelling had remained undiagnosed for 4 years. As the size of the swelling gradually increased, his parents brought him to Saveetha Dental College.

His parents were very apprehensive assuming that it could be a cancerous swelling in the jaw. Initial investigations revealed a large lesion in the right side of the lower jaw, which contained multiple hard structures at a single site. Radiographic investigations revealed multiple tiny radiopaque structures. The surgery was performed revealing a well-defined bag like mass, weighing about 200gms, which was removed in its entirety.

Histopathological investigation of the bag like mass by the oral pathologists revealed 526 tooth-like structures, about which they said: “it was reminiscent of pearls in an oyster.” It took 5 hours of laborious work to separate and remove all the minute teeth from the specimen. Each one of them resembled a tooth with a crown covered by enamel and a root-like structure. The tooth sizes varied from 1mm to 3mm. The postgraduate students said “This pandora box of miniature teeth is a jewel on our crown.”

Such lesions, where so many minute teeth were found in a single individual, single-site - are termed as “compound odontoma”, a benign tumour. Dr Pratibha Ramani, head of the hospital’s Department of Oral and Maxillofacial Pathology commented that, surprisingly, the boy was barely in any discomfort. “The only thing which was bothering him was that the tooth on that side had not erupted, it was empty, and [he had] occasional pain, and there was slight swelling that was increasing in size,” she added.

Earlier, in another similar case reported in 2014, ear, nose and throat surgeons at the JJ hospital's dental department in Mumbai had removed 232 teeth from the mouth of a 17-year-old boy.

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